Wiki Medicare Screening Colonoscopy LCD's

[Vanessa Treadway]

Is there a current Medicare LCD for High Risk Screening Colonoscopies? When I try to pull the last know LCD for this, it states it expired in November 2022 but then instructs you to scroll to the bottom and click on another one for current list. That list is titled Superseded at top and has no expiration date so I'm understanding it as being the most current list of covered codes. However, when you pull LCD's for Colonoscopy/Flex Sig/Proctosig, it does have procedure code of G0105 (High Risk Colon) listed as a covered code in that document. But that document doesn't have dx codes Z08 and Z83.71_, so I'm confused. Does anyone have clarification on this? Thank you

 

[CBLENNIE]

It is a bit of a coincidence that you posted this question today because this week's issue of MLN Matters happens to include a link to an article regarding the removal of the NCD for Coverage of Colorectal Cancer Screenings MLN Matters #: MM13017. The changes to the article are mostly about follow up colonoscopies after a positive/abnormal FOBT or Cologuard test, but the document but there is information on where to get information on coverage determinations since the NCD was removed. It includes information on where to find the information on CRC Screenings:


You may find information on coverage of high risk screening colonoscopies in one of the places listed under the CRC Screening header. Note this is a screen snip so none of the links work, you have to link to the article from the hyperlink I included above.