Does C9777 require prior authorization?

No, C9777 does not require prior authorization (high confidence). Covered without prior authorization.

`C9777`, Esophageal mucosal integrity testing by electrical impedance, transoral,

HCPCS/CPT

No Prior Auth Required

Covered without prior authorization (high confidence)

When manometry is used for pH tip placement, it should be considered part of the pH recording.
Coverage determinations must include review of the member's benefit contract or SPD for coverage definitions, exclusions, and limitations (e.g., dollar or duration caps).

Esophageal pH monitoring (catheter-based or wireless) is medically necessary for adults and children able to report symptoms in the following indications: documentation of abnormal acid exposure in endoscopy-negative patients considered for antireflux surgery; evaluation after antireflux surgery with suspected ongoing abnormal reflux; evaluation of reflux symptoms with normal/equivocal endoscopy refractory to PPI; evaluation of refractory reflux with chest pain after cardiac eval and 1-month PPI [...]
Esophageal pH monitoring (catheter or wireless) may be considered medically necessary for the clinical indications listed below in adults and children/adolescents able to report symptoms.
pH monitoring to document abnormal acid exposure in endoscopy-negative individuals being considered for surgical antireflux repair.
pH monitoring to evaluate individuals after antireflux surgery when ongoing abnormal reflux is suspected.
pH monitoring for individuals with normal or equivocal endoscopy and reflux symptoms refractory to PPI therapy.
pH monitoring to evaluate refractory reflux in individuals with chest pain after cardiac evaluation and after a 1-month trial of PPI therapy.

BCBSIL-MED201.005, Esophageal pH Monitoring

BCBSMT-MED201.005, Esophageal pH Monitoring

BCBSNM-MED201.005, Esophageal pH Monitoring

BCBSOK-MED201.005, Esophageal pH Monitoring

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