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Based on our review, we believe these services meet step 1 of our review process because they are currently assigned status indicator A (meaning that the service is separately payable under the PFS), meet step 2 of our review process because they are services ordinarily furnished with the furnishing practitioner and patient in the same location and therefore subject to the provisions of section 1834(m) of the Act, and meet step 3 because that all elements of these services may be furnished using an interactive telecommunications system as defined in 410.78(a)(3)

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Also, there is a coordination of neurons and pacemaker cells in the gastric mucosa known as the interstitial cells of Cajal within the stomach and small intestine and smooth muscles of the gut

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