CPT® Code 91117

1. Indications

The colon motility (manometric) study, as described by CPT® Code 91117, is indicated for patients presenting with severe constipation. This procedure is particularly relevant for evaluating whether the constipation is due to colonic inertia, a condition where the colon does not function properly to move stool through the digestive tract. The study helps in diagnosing underlying motility disorders that may contribute to the patient's symptoms.

• Severe Constipation This procedure is performed to assess the underlying causes of severe constipation, particularly when standard treatments have failed.
• Colonic Inertia The study is specifically indicated to determine if colonic inertia is the cause of the patient's constipation.

2. Procedure

The colon motility study involves several detailed procedural steps to ensure accurate measurement and recording of colonic activity. Initially, a thin manometry probe, which is equipped with multiple microsensors and a small balloon, is inserted into the rectum. The probe is then carefully advanced into the colon, allowing for the assessment of muscle and nerve activity throughout the intestinal tract. This probe is connected to a computerized device that continuously records the data as it is advanced.

• Insertion of the Probe The procedure begins with the insertion of the manometry probe into the rectum, which is then advanced into the colon to measure colonic motility.
• Continuous Recording The computerized device records muscle and nerve activity continuously for a minimum of six hours, capturing the contractions of the colon during this period.
• Provocation Tests Various provocation tests are performed, including the administration of a 1000-calorie meal, which allows for the monitoring of muscle tone and sensory changes over time.
• Intracolonic Balloon Distension The procedure may include intracolonic balloon distension, where the balloon is inflated and deflated with small amounts of air multiple times to assess muscle responses.
• Pharmacologic Agents If indicated, pharmacologic agents may be administered to stimulate colon contractions, with the corresponding muscle and nerve activity being recorded.
• Completion of the Study At the end of the study, the manometry probe, along with the attached sensors and balloon, is removed, and the physician reviews the collected data.

3. Post-Procedure

After the completion of the colon motility study, patients may experience some temporary discomfort due to the insertion of the probe. However, there are typically no significant post-procedure care requirements. The physician will analyze the recorded data and provide a written interpretation of the findings, which will be essential for determining the next steps in the patient's management plan. Patients may be advised to resume their normal activities unless otherwise instructed by their healthcare provider.