For dates of service beginning July 1, 2014, Harvard Pilgrim is expanding the covered indications for medically necessary capsule endoscopy of the small bowel to include:
- Suspected or known small bowel tumors
- Evaluation of celiac disease for members with a positive serology and negative biopsy
- Re-evaluation of members with celiac disease who remain symptomatic despite treatment
For more information, including coding details, please refer to the Gastrointestinal Payment Policy and the Capsule Endoscopy of the Small Bowel Medical Policy.