Category III Codes
J5 · Effective Oct 1, 2015
22 active Medicare policies list 91113, and 9 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
J9 · Effective Mar 28, 2021
J6 · Effective Apr 15, 2021
J6
JK · Effective Apr 15, 2021
JK
JE · Effective Mar 28, 2021
JF · Effective Mar 28, 2021
JH · Effective Mar 28, 2021
9 policies from 8 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 91113 |
|---|---|---|
| Capsule Endoscopy | Aug 30, 2023 | Covered |
| Colonoscopy, Colorectal Cancer Screening, and Related Procedures | Aug 1, 2023 | Covered |
| Policy | Effective | Status of 91113 |
|---|---|---|
| Wireless Capsule Endoscopy for Gastrointestinal Imaging and the Patency Capsule | Oct 1, 2026 | Covered |
| Policy | Effective | Status of 91113 |
|---|---|---|
JL · Effective Mar 28, 2021
JJ · Effective Apr 12, 2021
JM · Effective Apr 12, 2021
J5 · Effective Mar 28, 2021
J8 · Effective Mar 28, 2021
J6 · Effective Apr 1, 2026
National · Effective Jan 1, 2022
J9 · Effective Jan 1, 2022
JL · Effective Jan 1, 2022
National · Effective Sep 11, 2025
J5 · Effective Feb 23, 2023
National · Effective Aug 6, 2026
| Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders |
|---|
| Aug 1, 2026 |
| Covered |
| Policy | Effective | Status of 91113 |
|---|---|---|
| Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 91113 |
|---|---|---|
| Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 91113 |
|---|---|---|
| Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders | Aug 1, 2026 | Covered |
| Policy | Effective | Status of 91113 |
|---|---|---|
| Capsule Endoscopy | Feb 2, 2026 | Covered |
| Policy | Effective | Status of 91113 |
|---|---|---|
| Wireless Capsule Endoscopy for Gastrointestinal (GI) Disorders | Aug 1, 2026 | Covered |