What is the difference between Screening Colonoscopy, Diagnostic Colonoscopy, and Therapeutic Colonoscopy?How do you determine if insurance will cover one procedure versus the other? Here are answers to your question.
Screening colonoscopy is considered medically necessary when there is a family history of colonic adenomatous polyposis of unknown etiology (without known APC or biallelic MUTYH mutations) and when there are unexplained gastrointestinal tract bleedings, suspicions of inflammatory bowel disease, clinically significant diarrohea of unexplained origin, metastatic adenocarcinoma of unknown primary origin, or intraoperative identification of a lesion.
Diagnostic colonoscopy is considered medically necessary for an abnormality on barium enema or other imaging study likely to be clinically significant, unexplained gastrointestinal tract bleedings, suspicion of inflammatory bowel disease, clinically significant diarrohea of unexplained origin, metastatic adenocarcinoma of unknown primary origin, or intraoperative identification of a lesion.
Therapeutic colonoscopy is generally considered medically necessary for removal of foreign body, balloon dilation of stenotic lesions, excision of colonic polyps, decompression of sigmoid volvulus or an acute nontoxic megacolon, palliative treatment of stenosing or bleeding neoplasms, treatment of bleeding from lesions such as vascular malformation, ulceration, neoplasia, and polypectomy site.
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