Billing and Coding: Wireless Capsule Endoscopy

Coverage for wireless capsule endoscopy is determined by the reasonable and necessary criteria in LCD L35089. CPT/HCPCS coding for the procedure is subject to NCCI edits and billing must conform to NCCI guidance. Claims require documentation as specified in LCD L35089; this policy text does not itself define clinical indications, documentation details, or frequency limits.

"Wireless capsule endoscopy is covered when it meets the reasonable and necessary requirements specified in Local Coverage Determination (LCD) L35089."

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