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Colon Capsule Endoscopy (CCE): 7 Medicare contractor policies compared

7 Local Coverage Determinations in the current Medicare Coverage Database export carry the title "Colon Capsule Endoscopy (CCE)", between them covering 61 states and territories. 7 of them have a billing and coding article with a diagnosis list. The table below is the fastest way to see which version governs a given state and how far the versions have drifted.

QuickIntell editorial content · Legacy registry date · Review not verified

Data effective
Policies with this title
7
States covered
61
Versions with a coded article
7
Revision dates
2021-03-28 to 2026-04-01

Every version by contractor

Open a version for its full policy text, contracts, codes and related NCDs. Covered codes are the count of ICD-10-CM codes in the version's billing and coding article; a dash means the export attaches no coded article.

Local Coverage Determinations titled "Colon Capsule Endoscopy (CCE)"
LCDContractorStatesRevisedCovered codesPolicy words
L38571Wellpoint FederalCT DN IL MA ME MN NH NY QN RI UN VT WI2026-04-016377
L38755Palmetto GBAAL GA NC SC TN VA WV2021-04-126452
L38777CGS Administrators, LLCKY OH2022-01-306558
L38805First Coast Service Options, Inc.FL PR VI2021-03-286539
L38807Novitas Solutions, Inc.AR CO DC DE LA MD MS NJ NM OK PA TX2021-03-286539
L38824Noridian Healthcare Solutions, LLCAK AS AZ CA CNMI GU HI ID MT ND NF NV OR SD SF UT WA WY2025-09-116567
L38837Wisconsin Physicians Service Insurance CorporationAK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MO MS MT NC ND NE NH NJ NM NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY2025-05-296537

How to use the comparison

Start from the state where the service is furnished and open that contractor's version; its billing and coding article carries the diagnosis codes the claims system will test. For a group that bills in several jurisdictions, the version with the smallest covered list is the safe common denominator for pre-service review, and the version with the largest list shows what documentation can support an appeal elsewhere. The L38805 version is the one most searched for this title; the LCD lookup guide explains how jurisdictions are assigned, and the LCD hub lists every topic that more than one contractor has written.

Frequently asked questions

Why are there 7 LCDs called "Colon Capsule Endoscopy (CCE)"?

Each Medicare Administrative Contractor writes its own Local Coverage Determination for its jurisdiction. 7 contractors publish a policy with this title covering 61 states; they often start from one contractor's text and then revise separately, so dates, criteria and diagnosis lists differ by jurisdiction.

Which "Colon Capsule Endoscopy (CCE)" LCD applies to my claim?

The one written by the contractor that processes the claim: the A/B MAC for the state where the service is furnished, or the DME MAC region for equipment. The table lists each policy's states; open the policy for that jurisdiction and its billing and coding article.

How different are the diagnosis lists?

Among the 7 versions with a billing and coding article, the covered ICD-10-CM list ranges from 6 to 6 codes. A diagnosis accepted under one contractor can deny under another, which is the most common cause of coverage denials for multi-state groups.

When were these policies last revised?

Revision effective dates run from 2021-03-28 to 2026-04-01. A claim is judged against the version in force on the date of service.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

Policy metadata and code counts are reproduced from the CMS Medicare Coverage Database export as an operational reference. Verify against the current LCD and article on cms.gov before billing. Not legal, clinical or billing advice.