Billing and Coding: Colon Capsule Endoscopy (CCE)

Colon Capsule Endoscopy (CCE) may be covered when instrument colonoscopy was attempted and incomplete (Z53.8) or when optical colonoscopy is contraindicated as determined by a qualified endoscopist (Z53.09). Coverage is subject to the reasonable and necessary criteria in LCD L38805; services not meeting the LCD are non-covered and must not be billed as covered (use appropriate modifier). All medical records must be legible, include patient identifiers and provider signature, support the ICD-10-CM coding, and accurately reflect the CPT/HCPCS billed.

"Colon capsule endoscopy (CCE) is indicated when instrument colonoscopy has been attempted and was incomplete (use ICD-10-CM code Z53."

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