Peroral Endoscopic Myotomy (POEM)
JJ · Effective Feb 28, 2021
3 active Medicare policies list 43497, and 8 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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JJ · Effective Feb 28, 2021
JM · Effective Feb 28, 2021
National · Effective Jan 1, 2022
8 policies from 6 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 43497 |
|---|---|---|
| Dysphagia Therapy | Sep 12, 2023 | Covered |
| Gastric Pacing / Electrical Stimulation and Gastroesophageal Per Oral Endoscopic Myotomy | Sep 25, 2023 | Covered |
| Policy | Effective | Status of 43497 |
|---|---|---|
| Cigna Commercial Gastroenterology Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 | Prior auth required |
| Policy | Effective | Status of 43497 |
|---|---|---|
| Peroral Endoscopic Myotomy for Treatment of Esophageal Achalasia | Oct 1, 2025 | Covered |
| Policy | Effective | Status of 43497 |
|---|---|---|
| Minimally Invasive Procedures for the Treatment of Upper Gastrointestinal Diseases | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 43497 |
|---|---|---|
| Minimally Invasive Procedures for the Treatment of Upper Gastrointestinal Diseases | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 43497 |
|---|---|---|
| Gastroesophageal and Gastrointestinal (GI) Services and Procedures | Not recorded | Covered |