The Real Madrid star struggled with a foot injury over the summer, and was left on the substitutes bench during last week's defeat to Macedonia.
"I've got to look at the bigger picture. When we are selecting the team, we are thinking of sending players back fit and not risking them," The Mirror quotes Coleman as saying.
"We have to build long-term relationships and look after players properly. It's the same for all of them, whether it's Gareth, Aaron Ramsey or Jack Collison.
"Will Gareth be ready to start against Serbia? No. Can he play a part? We'll see."