What is the difference between a screening colonoscopy and a diagnostic colonoscopy?
Screening colonoscopies examine the colon to make sure it’s healthy. If your doctor finds and removes a polyp (abnormal growth), or finds a mass that needs to be biopsied, then it's considered a diagnostic colonoscopy.
You may need a screening, or preventive, colonoscopy if you do not have:
- Any symptoms of colorectal cancer
- Personal history of colon cancer or colon polyps
- A first-degree relative with a history of colon cancer or colon polyps
You may need a diagnostic colonoscopy if you have:
- Iron-deficiency anemia
- Persistent abdominal pain
- Blood in stool or bleeding from rectum
- A change in bowel habits that lasts more than a few days
- Personal or family history of colon cancer or colon polyps
Is there a cost difference between screening and diagnostic colonoscopies?
Medicare covers screening colonoscopies in full—you don’t have to pay a deductible or co-insurance. Most private insurance companies cover it, but you’ll have to call your insurance company to find out the details. Ask about any copays, deductibles, limits or exclusions that may apply.
Medicare covers diagnostic colonoscopies without a deductible. But you will pay 20-percent co-insurance. If you have private insurance, call to ask about your out-of-pocket costs.
Could I go in for a screening colonoscopy but then have to pay for a diagnostic colonoscopy?
Yes. Many people don’t have symptoms of polyps or early stage colorectal cancer. If your screening colonoscopy reveals a polyp or mass that needs to be biopsied (tested for cancer), then your procedure becomes a diagnostic colonoscopy.