Endoscopy Form

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Endoscopy

Indications

(355274) Is the endoscopic procedure deemed reasonable and necessary for the patient? 

Effective Date

01/01/2066

Last Reviewed

NA

Original Document

  Reference



Background for this Policy

Endoscopy is a technique in which a long flexible tube-like instrument is inserted into the body orally or rectally, permitting visual inspection of the gastrointestinal tract. Although primarily a diagnostic tool, endoscopy includes certain therapeutic procedures such as removal of polyps, and endoscopic papillotomy, by which stones are removed from the bile duct.

Endoscopic procedures are covered when reasonable and necessary for the individual patient.

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