Double Balloon Enteroscopy

Covered: DBE is medically necessary for dilation of small‑bowel Crohn’s strictures, evaluation of suspected small‑bowel malignancy, assessment after incomplete colonoscopy, suspected Meckel’s diverticulum with inconclusive imaging, and investigation of recurrent obscure small‑intestinal bleeding after nondiagnostic EGD and colonoscopy; DBE is experimental/investigational and not covered for all other indications (e.g., small‑bowel NET detection, intussusception treatment, post‑op bile leak, gossypiboma, pyogenic granuloma). Key requirements: prior upper and lower endoscopies must have failed to identify a bleeding source before DBE for obscure bleeding; for initial Crohn’s diagnosis DBE is allowed only when conventional tests (small‑bowel follow‑through, EGD, colonoscopy) are negative; there is no specific CPT for DBE (use related CPT/HCPCS) and certain ICD‑10 codes are excluded.

"For dilation of small bowel strictures in Crohn’s disease;"