Colonoscopy and Sigmoidoscopy-Diagnostic

This LCD covers diagnostic colonoscopy and flexible sigmoidoscopy for specific clinical indications including evaluation of imaging abnormalities, unexplained GI bleeding, positive stool tests, iron deficiency anemia, polyp/cancer assessment and certain therapeutic or palliative procedures. Routine or screening uses, and several non-specific or stable conditions (e.g., chronic IBS, acute limited diarrhea, hemorrhoids, routine preoperative evaluation for non-colonic surgery) are not covered; specified surveillance intervals apply for long-standing IBD and post-polypectomy or post-resection follow-up.

"Colonoscopy is covered to evaluate an abnormality on barium enema or other imaging likely to be clinically significant (e."

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