Diagnostic Esophagogastroduodenoscopy or Esophagoscopy - Medicare Advantage

This policy covers diagnostic esophagogastroduodenoscopy (EGD)/esophagoscopy (upper GI endoscopy), including transoral and transnasal approaches, for real-time visualization of the throat, esophagus, stomach and proximal duodenum to evaluate esophageal disease, Barrett’s esophagus, suspected gastrointestinal cancers and related diagnostic indications. Coverage is limited to diagnostic (not screening, surveillance, or therapeutic) uses and is subject to Medicare NCD/LCD/LCA medical necessity criteria, applicable MAC jurisdictional rules, and any frequency/eligibility limitations specified in the referenced CMS LCDs and guidance.

"NCD 100."

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