Wireless Capsule Endoscopy

Wireless capsule endoscopy (WCE) of the small bowel is covered for obscure small bowel bleeding (documented continuous blood loss with anemia) when prior upper endoscopy and colonoscopy or radiographic studies have failed to identify the source, when intraoperative enteroscopy is being considered, and for initial evaluation of suspected Crohn's disease if conventional tests are negative. Esophageal capsule endoscopy is covered only for portal-hypertension patients needing urgent evaluation of esophageal varices when conventional endoscopy is contraindicated and the record documents the contraindication and expected benefit. WCE is not covered for colorectal cancer screening, must use FDA‑approved devices, is contra-indicated with pacemakers or confirmed bowel obstruction/stricture/fistula, and small bowel WCE is payable only once per episode of illness after prior negative scopes.

"Wireless capsule endoscopy (WCE) of the small bowel is covered for patients with documented continuous blood loss and anemia secondary to obscure small bowel bleeding when prior upper endoscopy and..."