Diagnostic and Therapeutic Colonoscopy (L34213) - R16 - Effective November 6, 2025

Date Posted: February 13, 2026

This Local Coverage Determination (LCD) has been revised under contractor numbers: 02102 (AK), 02202 (ID), 02302 (OR), 02402 (WA), 03102 (AZ), 03202 (MT), 03302 (ND), 03402 (SD), 03502 (UT), and 03602 (WY).

Effective Date: November 6, 2025

Summary of Changes: Under Coverage Indications, Limitations and/or Medical Necessity, removed the broken link to the Internet Only Manual (IOM).

Visit the Noridian Active LCDs webpage to view the Active LCD or access it via the CMS MCD.

Last Updated Feb 13 , 2026