Virtual Upper Gastrointestinal Endoscopy – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare designates virtual upper GI endoscopy using 3‑D CT or 3‑D MRI as unproven and not medically necessary (not covered) for detection or evaluation of upper GI lesions due to lack of high‑quality evidence, inability to perform biopsy, limited anatomic detail, and radiation exposure. If a lesion is suspected or identified, conventional optical endoscopy with tissue sampling is required, and coverage decisions/reimbursement follow the member’s specific benefit plan (prior authorization or plan‑specific requirements may apply; listed CPT codes are for reference only).

"None. Virtual upper gastrointestinal (GI) endoscopy using 3-D CT or 3-D MRI is considered unproven and not medically necessary for detecting and evaluating upper GI lesions due to insufficient evid..."

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