NCDActive
Injection Sclerotherapy for Esophageal Variceal Bleeding
NCD95
Effective: October 29, 1984
Updated: December 31, 2025
Policy Summary
Medicare covers injection sclerotherapy for esophageal variceal bleeding. The procedure is an endoscopic injection of a sclerosing agent into esophageal varices; this NCD provides no additional clinical eligibility criteria, coding guidance, documentation requirements, or frequency limits, so local/carrier rules may apply.
Coverage Criteria Preview
Key requirements from the full policy
"Injection sclerotherapy is covered for treatment of esophageal variceal bleeding."
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Covered Medical Codes