Welcome to our Patient Education page!
Screening or Diagnostic Colonoscopy?
The patient has past and/or present gastrointestinal symptoms, polyps, GI disease, iron deficiency anemia and/or any other abnormal tests OR the patient is currently asymptomatic (no gastrointestinal symptoms either past or present) but has a personal history of GI disease, personal and/or family history of colon polyps and/or colon cancer. Patients in this category are required to undergo colonoscopy surveillance at shortened intervals (e.g. every 2-5 years).
Insurance plans process these claims subject to the individuals deductible and co-insurance requirements.
Preventative Screening Colonoscopy:
The patient is asymptomatic (no gastrointestinal symptoms either past or present), age 50 or greater, has no personal or family history of GI disease, colon polyps, and/or cancer. The patient has not undergone a colonoscopy within the last 10 years.
Insurance plans usually process these claims under the wellness benefit, payable at 100% if it is a benefit of the individual’s health insurance plan.
Frequently asked questions:
Who will bill me?
You may receive bills for your procedure from the physician, the facility, anesthesia, pathologist and/or laboratory.
Can the physician change, add, or delete my diagnosis so that my procedure can be considered a preventative/wellness/routine screening?
NO! The patient encounter is documented as a medical record from the information you have provided, as well as what is obtained during our pre-procedure history and assessment. It is a binding legal document that cannot be changed to facilitate better insurance coverage.
What if my insurance company tells me that the doctor can change, add or delete a CPT or diagnosis code?
This happens a lot. Often the representative will tell the patient that if the “doctor had coded this as a screening, it would be paid at 100%." A member services representative should never suggest a physician alter a medical record for billing purposes.
Our Blog Posts
- Everything You Need to Know About FibroScan® Testing
- How Serious is Nonalcoholic Steatohepatitis?
- GI Conditions That May Contribute to Blood in the Stool
- I Think I Have Celiac Disease. What Now?
- How Do I Find the Right Gastrointestinal Doctor for Me?
- June Week 1
- How Do I Know if I Have FLD or Cirrhosis?
FAQS - Frequently Asked Questions
This information was developed by the Publications Committee of the American Society for Gastrointestinal Endoscopy (ASGE). For more information about ASGE, visit www.asge.org.
This information is intended only to provide general guidance. It does not provide definitive medical advice. It is important that you consult your doctor about your specific condition.
Why Should You Choose an ASGE Member for Your Endoscopic Procedure?
Having an ASGE member perform your endoscopic procedures ensures that you are in the hands of someone who is highly trained. Physicians and surgeons who are members of the American Society for Gastrointestinal Endoscopy (ASGE) have highly specialized training in endoscopic procedures of the digestive tract, including upper GI (gastrointestinal) endoscopy, flexible sigmoidoscopy, colonoscopy, endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS).
ASGE members undergo a rigorous application and screening process and are recognized by the medical community as knowledgeable, experienced experts in gastroenterology and GI surgery who, in addition, have advanced training in gastrointestinal endoscopic procedures.
ASGE members have demonstrated proof of rigorous endoscopic training. The American Society for Gastrointestinal Endoscopy is the only medical society that requires documentation of specific training in GI endoscopic procedures.
How will your GI endoscopist work with your primary care physician?
ASGE physicians usually work on referral from your primary care physician. Your GI endoscopist will communicate with your primary care physician about the results of your endoscopic procedure. Together, they will determine what is appropriate for treatment, follow-up visits and/or if future endoscopic exams are needed.
Is your physician an ASGE member? Ask.
Make the best choice. If you need an endoscopic procedure, ask your primary care doctor to recommend a specialist in gastrointestinal endoscopy who is also an ASGE member. ASGE members are distinctively qualified to perform the gastrointestinal endoscopic procedures that your primary care physician or other healthcare provider recommends and to work with you and your primary care provider on issues of digestive health.
Find an endoscopist in your area.
ASGE can help you find a GI endoscopist in your area. It's easy. Visit the ASGE Web site at www.asge.org and click on the Find an Doctor. By typing in your zip code, the Find a Doctor program will give you a list of the ASGE members in your area. Remember, you can always ask if your physician is an ASGE member.
Need more information on endoscopy or colonoscopy?
ASGE offers additional materials on GI endoscopy and endoscopic procedures including brochures on Upper GI Endoscopy, Endoscopic Ultrasound, ERCP, Flexible Sigmoidoscopy and Colonoscopy on the ASGE Web site at www.asge.org as well as other useful information on digestive health and gastrointestinal problems.
Make the Best Choice for Your Endoscopic Procedure-An ASGE Gastrointestinal Endoscopist
ASGE Active Physician Members have met the following rigorous requirements:
- Unlimited medical license.
- Graduation from an accredited medical school and completion of a residency program.
- Documented evidence of formal training in gastrointestinal endoscopy under the supervision of certified gastroenterologists or gastrointestinal surgeons - ASGE is the only society that requires evidence of such training.
- Finally, ASGE Active Members must provide evidence of professional competence through sponsorship by at least one member who has personal knowledge of the applicant's endoscopic training and skills.
Be certain your physician meets the high standards of ASGE membership.