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Screening VS. Diagnostic Colonoscopy

Knowing the difference between a screening and diagnostic colonoscopy is very important.  Your insurance company will determine your benefits based on the type of procedure you have and this may affect your out of pocket costs.

Screening Colonoscopy

  • Preventative
  • Patient usually over 50.
  • Asymptomatic - no symptoms past or present.
  • No findings during the procedure.
  • No personal history or family history of colon cancer, polyps, or gastrointestinal disease.


Diagnostic Colonoscopy

  • Patient having symptoms, such as: rectal bleeding, abdominal pain, change in bowel habits, or iron deficiency anemia.
  • Personal or family history of polyps, cancer, or gastrointestinal disease.  Some insurance companies consider screening because of a family history a 'High Risk Screening' instead of a diagnostic colonoscopy. 
  • Findings during a screening colonoscopy may change it to a diagnostic depending on the insurance company.

You should speak with your insurance company prior to your procedure to make sure you understand their criteria for each type of procedure and what your benefits will be.