Colon Capsule Endoscopy (CCE) Final LCD - R1 - Effective December 19, 2021

This Local Coverage Determination (LCD) has completed the Open Public Meeting comment period and is now finalized under contractor numbers: 01112 (NCA), 01182 (SCA), 01212 (AS, GU, HI, and NMI), and 01312 (NV).

Medicare Coverage Database Number LCD Title
L38824 Colon Capsule Endoscopy (CCE)


Medicare Coverage Database Number Billing and Coding Article Title
A58436 Billing and Coding: Colon Capsule Endoscopy (CCE)
A58944 Response to Comments: Colon Capsule Endoscopy (CCE)


Effective Date: December 19, 2021
Summary: This LCD provides limited coverage for a Diagnostic Colon Capsule endoscopy (CCE). Colon capsule endoscopy (CCE) is a noninvasive procedure that does not require air inflation or sedation and allows for minimally invasive and painless colonic evaluation. CCE utilizes a tiny wireless camera that takes pictures of the gastrointestinal tract. The wireless camera is housed inside a vitamin-size capsule that is swallowed with water. As the capsule travels through the digestive tract, the camera system takes pictures. The images are then transmitted to a computer with special software where the images are strung together to create a video. The provider reviews the video to look for any abnormalities within the gastrointestinal tract. The LCD was updated to acknowledge FDA approved blood-based biomarker testing that could be used for screening purposes.

Visit the CMS Medicare Coverage Database (MCD) to access this LCD.

            Last Updated Tue, 09 Nov 2021 19:54:43 +0000