Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

This LCD covers colonoscopy/sigmoidoscopy/proctosigmoidoscopy when performed for diagnostic, surveillance, therapeutic, or intraoperative indications (non-screening), including evaluation of significant imaging abnormalities, unexplained GI bleeding, iron deficiency anemia, surveillance of colonic neoplasia, management or assessment of chronic IBD when it affects care, and specified therapeutic interventions. Routine or stable conditions such as chronic stable IBS, acute diarrhea, hemorrhoids, routine preoperative exams for non-colonic disease, and situations where an upper GI source is demonstrated are generally not covered; additional documentation and beneficiary notice are required when services may be non-covered.

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