September 2017

Colonoscopies are either diagnostic or preventive.  The difference between the two is sometimes hard to distinguish, but there is big difference on how insurance companies cover either procedure.  Knowing the difference between the two types of colonoscopies is an important step before scheduling your colonoscopy.  We have included a general rule of thumb below; however, please make sure to consult with your physician and your insurance plan for a more detailed and personalized view of the different types of colonoscopies.

• A preventive or screening colonoscopy is performed on a patient who is asymptomatic (no gastrointestinal symptoms either past or present), is 50 years of age or older, and has no personal or family history of colon polyps and/or colon cancer.
• A diagnostic colonoscopy is performed on a patient who has gastrointestinal symptoms (e.g. rectal bleeding, abdominal pain, diarrhea) and who has past and/or present polyps or gastrointestinal disease (e.g. Crohn’s Colitis, etc.).
• If polyps are found, removed or biopsied during a screening colonoscopy, most insurance carriers re-categorize the screening colonoscopy as a diagnostic colonoscopy (and your screening benefit may no longer apply).

For more information on colonoscopies visit the National Institutes for Diabetes and Digestive and Kidney Diseases’ Colonoscopy webpage.