Colonoscopy: what it is and in which cases it is recommended

Colonoscopy is a diagnostic test that is usually requested to diagnose lesions or pathologies in the large intestine, rectum, or ileum. It is an invasive procedure, but quite simple, thanks to which numerous diseases can be detected in their early stages, when they are fully treatable.

What is a colonoscopy

It is an exploratory test thanks to which the doctor can observe the walls of the intestine, with the intention of detecting possible abnormalities. It is performed using a device called a colonoscopy, a long, thin tube equipped with a camera and a light to record and send real-time images of the state of the colon.

Why is a colonoscopy requested?

This test is usually requested by a doctor specializing in the digestive system, with the aim of having first-hand information on what happens inside the intestine.

It is usually recommended when there is suspicion of some type of pathology, not necessarily serious, or to rule out important problems.

Despite being an invasive test, it does not have any type of complication and is performed on an outpatient basis. The patient comes and leaves the clinic the same day and by his own foot.

The most frequent reasons for which a colonoscopy can be requested are the following:

      Abdominal pain without apparent cause and that does not subside.

      Presence of polyps, which could have been previously detected by means of an X-ray.

      Persistent anemia for no other reason found.

      Blood in the stool.

      Stools of unusual color.

      Rapid weight loss for no apparent reason.

A colonoscopy can also be requested to monitor a pathology already diagnosed, such as colon cancer, Crohn's disease or ulcerative colitis, among others.

How is this test done?

Before performing the colonoscopy it is necessary to clean the intestine. To do this, the patient must fast for the hours prior to the intervention and not eat solid food for at least three days before the test is performed.

In addition, before going to the consultation, the specialist will surely recommend the use of laxatives and the use of an enema. To help empty the intestines, it is advisable to drink a lot of water and other liquids such as infusions or defatted broth.

Before starting the test, some medications are administered to the patient so that they are relaxed during the test and so that they do not feel any type of discomfort.

During the colonoscopy, the patient should lie on his side, with the knees bent to facilitate the introduction of the colonoscope. The specialist will introduce the device slowly, observing the walls of the intestine at all times in search of some type of anomaly.

Before, through the tube, air is introduced to distend the intestinal walls and to be able to observe and intervene more easily. If anything unusual is observed, tissue samples may be taken for analysis.

After the colonoscopy, the patient may experience mild discomfort for 24 hours. Gas and a slight burning in the stomach are usually felt.

What parts of Medicare cover colonoscopy?

Medicare includes different parts that provide coverage for different types of medical services. In this section we describe how each part may or may not cover a colonoscopy.

Medicare Part A

Medicare Part A is the part of Medicare that covers hospital-related costs. If you need inpatient hospital care, Medicare Part A is the part of your insurance that pays for these costs.

Sometimes someone may be in the hospital and need a colonoscopy. Let's say you experience a gastrointestinal (GI) bleed. Medicare Part A will pay for these services and Medicare Part B (information later) will pay for your doctor's services while you are in the hospital.

Medicare may require you to pay a copayment or deductible for services you receive in the hospital. Typically, this is a one-time payment for up to 60 days of hospital stay.

Medicare Part B

Medicare Part B is the part of Medicare that pays for medical services and preventive care. This is the part that covers outpatient care for services like a colonoscopy.

A person pays a monthly fee for Medicare Part B and has an annual deductible. The deductible varies from year to year, but in 2020 it is $198.

However, Medicare does not require you to meet your deductible before paying for a colonoscopy, and they will pay regardless of whether the colonoscopy is for screening or diagnostic fees.

Medicare Part C

Medicare Part C, or Medicare Advantage, is a Medicare plan that includes Part A, Part B, and certain prescription drug coverage. The Medicare Advantage Plan must cover screening colonoscopies as mandated by the Affordable Care Act.

The main consideration if you have Medicare Part C is to make sure the doctor and anesthesia providers are in your plan's network, since many Medicare Advantage plans require you to seek care from specific providers.

Medicare Part D

Medicare Part D is prescription drug coverage that a person could buy in addition to the other parts of Medicare. Some Medicare Part D plans may cover prescriptions for a bowel preparation that helps clean out the colon before a colonoscopy.

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