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Colonoscopy: Screening or Diagnostic?

Please read through this Q&A to understand your colonoscopy before scheduling an appointment with Dr. Asamoah.

What are the colonoscopy categories?

Diagnostic/Therapeutic Colonoscopy:
You have had past and/or present gastrointestinal symptoms, polyps, GI disease, iron deficiency anemias, and/or any other abnormal tests.

Surveillance/High-Risk Screening Colonoscopy:
You aren’t showing any signs of gastrointestinal symptoms (past or present) but do have a family history of GI disease, colon polyps, and/or colon cancer.

Preventative Screening Colonoscopy:
You aren’t showing any signs of gastrointestinal symptoms (past or present), over the age of 50, have no family history of GI disease, colon polyps, and/or colon cancer.

Can a screening turn into a diagnostic colonoscopy?

Yes, it is possible. Before your procedure, it is very important that you know your colonoscopy category.

If polyps are detected during your screening and results in removal and biopsy, the screening will be classified as a diagnostic colonoscopy. This may change your insurance benefits for the procedure and additional costs may be incurred.

Remember that coding of the procedure is also based on the doctor’s evaluation when it comes to your symptoms and insurance coverage. Please be truthful with your doctor when it comes to your GI symptoms and history (past and present) to prevent unexpected code changes and charges.

Screening or Diagnostic – What’s the difference?

A screening colonoscopy is a preventative procedure meant to evaluate the health of a patient’s colon. Screenings are covered by Medicare and typically covered by insurance after the age of 50 as a preventative measure against colon cancer.

Can the doctor change my diagnosis code?

No! It is against the law for your doctor to change your code (no matter what your insurance may tell you) and is considered insurance fraud. Your medical record is a binding legal document that cannot be changed to facilitate better insurance coverage.

This is why it is important to be truthful and report any symptoms to your doctor, along with understanding what your insurance will cover so that you don’t have any surprises.

Who will bill me?

You may receive bills for separate entities associated with your procedure, besides your doctor. This includes the facility, anesthesia, pathologist, and/or laboratory. We can only provide you with information associated with our fees.

It is important that you ask your insurance provider to verify the benefits and costs with these additional entities.

How long does it take for me to find out my results?

We make it a mission to share your results with you as soon as available. We do not share pathology or imaging with patients nor discuss results over the phone unless approved by the physician. We prefer you to come into the office for a face-to-face discussion of the results.

It’s Time to Reclaim Your Health