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NCD Manual section 100: Gastrointestinal System

Section 100 of the Medicare National Coverage Determinations Manual (Pub. 100-03, chapter 1, part 2) holds 13 National Coverage Determinations on gastrointestinal system. Each binds every Medicare Administrative Contractor; this page lists them with their effective dates, the local policies that cite them and the contractor articles that turn them into claim edits.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: Medicare Coverage Database NCDs: API snapshot September 27, 2026 (effective September 20, 2026); Medicare Coverage Database billing and coding articles: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: weekly, every Thursday.

NCDs in the section
13
5 with a full reference page
Laboratory NCDs
0
Cited by local policies
5
22 LCD citations
With contractor articles
4
11 articles
Coverage analyses linked
9
Newest effective date
2023-04-10
NCD 100.14

Every NCD in section 100

Local policies counts the active LCDs that list the NCD as related; contractor articles counts the current Medicare Coverage Database articles that name it. NCDs with an indexed reference page are linked; the others are listed by number and title.

National Coverage Determinations in NCD Manual section 100, Gastrointestinal System
NCDTitleBenefit categoryEffectiveLocal policiesContractor articles
100.1Bariatric Surgery for Treatment of Co-Morbid Conditions Related to Morbid ObesityIncident to a physician's professional Service, Inpatient Hospital Services, Physicians' Services2013-09-2435
100.2EndoscopyDiagnostic Tests (other), Physicians' Serviceslongstanding124
100.324-Hour Ambulatory Esophageal pH MonitoringDiagnostic Tests (other)1985-06-1131
100.4Esophageal ManometryDiagnostic Tests (other)1978-10-0221
100.5Diagnostic Breath AnalysesDiagnostic Tests (other)1984-06-12——
100.6Gastric FreezingPhysicians' Serviceslongstanding——
100.7Colonic IrrigationPhysicians' Serviceslongstanding——
100.8Intestinal Bypass Surgery - RETIREDInpatient Hospital Services, Physicians' Services2023-04-10——
100.10Injection Sclerotherapy for Esophageal Variceal BleedingPhysicians' Services1984-10-292—
100.11Gastric Balloon for Treatment of Obesity - RETIREDPhysicians' Services2023-04-10——
100.12GastrophotographyDiagnostic Tests (other), Physicians' Serviceslongstanding——
100.13Laparoscopic CholecystectomyInpatient Hospital Services, Outpatient Hospital Services Incident to a Physician's Service, Physicians' Services1991-11-18——
100.14Surgery for Diabetes - RETIREDPhysicians' Services2023-04-10——

What the section covers and how to read it

The NCD Manual groups national policies by body system or service type, and the section number is the first part of every NCD number in it. Section 100 covers gastrointestinal system. Most of its NCDs fall under the Physicians' Services (5), Diagnostic Tests (other) (3), Diagnostic Tests (other), Physicians' Services (2) benefit categories, which decide whether Medicare can pay for the item at all before the NCD's clinical criteria are applied. Effective dates in the section run from 1978-10-02 (NCD 100.4) to 2023-04-10 (NCD 100.14); 4 NCDs are longstanding policies for which CMS has not posted the effective date of the current version. A claim is judged against the version in force on the date of service, so the effective date and the revision history on each NCD page matter as much as the criteria.

Read an NCD in three layers. The item or service description says what the policy is about; the indications and limitations say when Medicare covers it, often with documentation, setting or frequency conditions; and the contractor articles say how the claim must be coded for the national criteria to be applied automatically. In this section 4 NCDs have such contractor articles, listed on each NCD page under "How MACs bill" with their covered ICD-10-CM codes. Where a contractor has also written a Local Coverage Determination that cites the NCD, the LCD adds local documentation and coding detail but cannot narrow or widen the national coverage.

Local policies and contractor articles

5 of the 13 NCDs in this section are cited by active Local Coverage Determinations, 22 citations in all; 4 have contractor billing articles (11 articles across the Medicare Administrative Contractors). To see what applies to a claim, open the NCD, then the local policy and article of the contractor that processes it: the LCD list carries every active local policy, the LCD lookup guide explains which contractor covers which state, and the code-and-diagnosis checker tests one procedure code and one ICD-10-CM code against every article that applies in a state. A denial under an NCD returns CARC 50 with remark N386.

The most searched NCD in this section is NCD 100.1 Bariatric Surgery for Treatment of Co-Morbid Conditions Related to Morbid Obesity, at about 70 US Google searches a month for its number.

Other sections of the NCD Manual

Chapter 1 of the manual is published in four parts on cms.gov; every section with a current NCD has its own page here.

Where QuickIntell fits in coverage checks

QuickAuth coordinates requirement checks, documentation, submission and status tracking for prior authorization with human review, so national and local coverage criteria are looked at before the service. QuickRCM picks up the claim and any coverage denial afterwards.

See QuickAuth for requirement checksSee QuickRCM for coverage denialsBook a meeting

Frequently asked questions

Which NCDs are in NCD Manual section 100?

Section 100, Gastrointestinal System, holds 13 National Coverage Determinations in the current Medicare Coverage Database: 100.1 Bariatric Surgery for Treatment of Co-Morbid Conditions Related to Morbid Obesity; 100.2 Endoscopy; 100.3 24-Hour Ambulatory Esophageal pH Monitoring; 100.4 Esophageal Manometry; 100.5 Diagnostic Breath Analyses; 100.6 Gastric Freezing; 100.7 Colonic Irrigation; 100.8 Intestinal Bypass Surgery - RETIRED; and 5 more listed on this page.

How are NCD numbers assigned?

An NCD number is its place in chapter 1 of the NCD Manual: the part before the dot is the section (100 here), and the rest orders the policies inside it. Section 100 is in part 2 of the chapter. The number stays with the policy when CMS revises it; each revision gets a new version and transmittal instead.

Do Medicare contractors add local rules to section 100 NCDs?

5 of the 13 NCDs are cited by at least one active Local Coverage Determination, and 4 have contractor articles that implement them in the Medicare Coverage Database. A local policy may add documentation and coding detail but may not contradict the national determination.

How current is this list?

It is rebuilt from the CMS Coverage API NCD records and the weekly Medicare Coverage Database article export. The most recent effective date in the section is 2023-04-10 (NCD 100.14); 4 are longstanding NCDs whose current-version effective date CMS has not posted.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

NCD titles, dates and counts are compiled from the CMS Coverage API and the Medicare Coverage Database export as an operational reference. Coverage depends on the full policy text, the claim and the contractor; verify against the current NCD on cms.gov. Not legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.