LCD/NCD Portal

NCD100.2

 

ENDOSCOPY

 

 

Effective Date of this Version

• This is a longstanding national coverage determination.

• The effective date of this version has not been posted.

 

Benefit Category

• Diagnostic Tests (other).

• Physicians' Services.

• Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

 

Item/Service Description

• Endoscopy is a technique in which a long flexible tube-like instrument is inserted into the body orally or rectally, permitting visual inspection of the gastrointestinal tract.

• Although primarily a diagnostic tool, endoscopy includes certain therapeutic procedures such as

o Removal of polyps.

o Endoscopic papillotomy, by which stones are removed from the bile duct.

 

Indications and Limitations of Coverage

• Endoscopic procedures are covered when reasonable and necessary for the individual patient.

 

 

Medicare NCD Link