Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy

Coverage for diagnostic and therapeutic esophagogastroduodenoscopy (EGD) is contingent on meeting the reasonable and necessary criteria in LCD L33583. Claims must be supported by complete, legible medical records that justify the selected ICD-10-CM and CPT/HCPCS codes, include the ordering physician's reason and procedure results, and contain the responsible clinician's signature. Non-covered services must not be billed as covered and appropriate modifiers should be used when billing non-covered services.

"Esophagogastroduodenoscopy (EGD) is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination L33583."

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