Billing and Coding: Colon Capsule Endoscopy (CCE)

Billing for colon capsule endoscopy is allowed only when supported by the related LCD L38837: specifically when instrument colonoscopy was attempted and incomplete (ICD-10 Z53.8) or when optical colonoscopy is contraindicated as determined by an appropriately trained physician (ICD-10 Z53.09). All medical records must be legible, include patient identification and the responsible provider's signature, and must support the selected ICD-10 and CPT/HCPCS codes; non-covered services must be billed using the appropriate modifier.

"Colon capsule endoscopy may be billed when an instrument colonoscopy was attempted and was incomplete, documented with ICD-10-CM code Z53."

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