Insurance question - my colonoscopy should’ve been covered 100% as a screening procedure. They found and removed one small polyp, so now they aren’t billing it as a screening colonoscopy and I have a $425 bill. Is this common, or should I ask them about it?
StG
Removing the polyp turned it into ‘treatment’ and subject to your deductible/out of pocket as they apply to medical treatment.
It would be the same for me here in Nebraska, as it was explained to me before my last ‘screening/preventative’ colonoscopy. [Medicare-BC/BS supplemental]
I’ve heard much the same, about a polyp removal during a screening procedure turning it into a regular thing versus 100%-covered screening.
Which is a complete and utter scam. You don’t KNOW there are polyps until they DO THE DAMN SCREENING.
I can certainly see some additional hilling for a) any pathology testing or extra handling required for the specimen, and b) if the procedure takes longer than usual due to the polyp removal. That seems fair. But that would be add-on costs only.
Bastards.
In my case, that shit (ship) has sailed - mine are NOT simple screening colonoscopies.
Hubby had his on yesterday, upper andlower. He’s on a yearly for lower since one of his polyps came back cancerous about 12, 13 years ago. They couldn’t be sure they got all of it because it was so close to the edge of where they’d cut. He had to have a bowel resection done and up to now, no problems. This time, they removed one from the upper and one from the lower.
I just read his test results in our health app. Upper was fine. Lower was tubular adenoma. I’m trying to keep things in perspective (and not say anything to him until he says something to me - I’m so tired of being the one to bring potentially bad news.) We just have to wait until the doctor gets back to us.
TruePisces - i had a colonoscopy this February and had a polyp come back as tubular adenoma. MD said it’s pre-cancerous, no additional treatment needed, come back in 5-7 years. I wouldn’t worry too much about it at this point - this is why they’re doing yearly screenings. It should’ve been small.
Good luck…
StG
StG, we heard from his doctor today and he said the same thing so my worries are set aside for now. Did you have yours done at Vandy? With Verrain working there, we have pretty much everything done there.
TruePisces - Glad to hear it! No, I had mine done at an endo center here in M’boro. Since I’m single, getting the ride is the hard part.
StG
That’s true. And they are pretty big sticklers for that. In the past, we’ve had some tough times making sure we could get kids to school and us to Vandy. I’m REALLY looking forward to next year when (hopefully) my 17 year old will have their license and be able to drive both themself and their brother to school - the first time they’re in the same school since CtY was in 4th grade. It’ll make life so much easier.
I’ve tooted this horn before, but if you can get it done without sedation you can drive yourself there and back.
How uncomfortable is it? Can you compare the discomfort level to something I might be familiar with?
StG
It depends both on your gut and the skill of your physician, I suspect. Mostly, it just feels a little weird, but there’s discomfort as the front of the tube goes around curves. The first time I did it, there were a few seconds when I gripped the rails along the bed pretty hard and clenched my teeth, but it was only a few seconds. The second time (I’ve only done it twice) I was chatting with the physician, and barely noticed until I suddenly said “ouch” and he apologized, saying he’d just rounded a curve, but the pain was basically gone by the time he apologized. They shove the tube all the way up, and do the exam as they slowly pull it out, and I didn’t find the exam part uncomfortable at all, and enjoyed the guided tour of my innards. (The second doctor gave a guided tour. The first one only spoke when I spoke to him.) I suppose if you were apt to get anxious when the doctor spends a lot of time examining a small bump, it might be disconcerting. (just a small diverticula, not a polyp, in my case.)
I think the pain is more like an abdominal cramp than anything else I can think of, but those last for a while, and this is very brief. Literally a few seconds here and there.
My brother, who had an unexpected unsedated colonoscopy (he had a can of diet soda on the way into the procedure, and they said the colonoscopy was safe, but sedating him wasn’t. He decided he didn’t want to re-do the prep) complained that his colon is very sensitive and he felt every little bump. He was angry that they hadn’t warned him not to drink the soda. I have a friend who had to do one unsedated for some medical reason, and she was appalled when she farted in the doctor’s face. I assured her that 100% of his patients did that, but she felt that it was different because she was awake.
A friend that I talked into trying it unsedated said “I guess my colon isn’t very kinky, it was easy”. On the other hand, if you wake up from colonoscopies feeling painfully bloated, I assume that’s worse during the exam. The “this part of my intestine has been inflated with air/CO2” didn’t bother me at all, either during or after. I also rarely have pain from gas (I just fart if I eat gassy foods, I don’t usually feel discomfort.) YMMV. the newer procedure is to use CO2 instead of air, which can be absorbed by the body, so there’s less distension and little farting after the procedure. (and none during) That may not have caught on everywhere, yet.
Women have kinkier colons then men, because of the uterus and stuff in the same general area. (Trans men should inform their doctor that they have or used to have a uterus prior to a colonoscopy.)
In many countries it’s standard to do it without sedation, and like an MRI they only use sedation if they think there might be a problem for the patient. It’s WAY less painful that having an IUD inserted, which is routinely done unsedated in the US. WAY WAY less painful. I can only assume that men’s pain matters more than women’s.
All this is for a colonoscopy. I’ve also had unsedated upper GI scopes, and that is incredibly uncomfortable because it triggers your gag reflex. I have had issues with sedation, but I would recommend you get sedated for an upper scope (if you aren’t me.)
I know one guy who said he asked for an unsedated colonoscopy and his doctor said “no, there’s too much risk you will move and I’ll perforate your bowel”. I’ve read studies that found the risk of bowel perforation is actually higher with sedation (because the patient doesn’t say “ouch”) and there isn’t a reflex to move suddenly when you feel something uncomfortable in the gut. So I’m pretty sure that’s completely bogus. But there are risks with any procedure, and you don’t want to pressure a doctor into doing something they aren’t comfortable doing.
That is a huge hassle for so many people. I’m actually going to drive a friend of ours for his, in about a month - he lives 100ish miles away, but I’ve said publicly for years that I’d drive anyone anywhere nearby.
TriuPisces: glad your husband’s report came back as “nothing urgent”. I forget which “flavor” of adenomas I tend to develop. Mine are sessile - which a) is harder to spot, and b) I think is likelier to go bad at some point.
Size DOES matter, too - the larger it gets, the higher a chance it is or will become cancerous. Hence my 2 cm monster getting me promoted to an annual schedule. My prjmary care doc was pretty impressed.
FYI, your “ride” can simply be a responsible adult who goes along with you in a cab - it does NOT need to be someone actually driving you. I did that for a friend’s procedure of some sort (forget which it was; I don’t think it was a colonoscopy) shortly after I had wrist surgery.
So, bring the kid along even if he cannot drive, tell the place he’s your escort… and don’t mention that he’s not yet 18. Hell, for one of mine, they didn’t even verify that my son was in the waiting room (he wasn’t; he’d gone for some breakfast nearby). They did not walk me out to him - so I could have lied about the whole thing. Since COVID, their procedures have changed: my ride cannot wait inside, they call the ride when I’m ready, and they now escort me out to meet my ride. It’d actually be HARDER to pull one over this way.
I know what that’s like. In fact, my doctor let me get away with Cologuard in place of a full colonoscopy the last two times (ages 55 and 60).
“Ask a relative” - none live anywhere near me.
“Ask a neighbor” - I don’t know any of them well enough, and besides, I seriously doubt any of them can take pretty much an entire day off just to drive me to the office (which was about 30 miles from where I live, the last time I had one), wait there for who knows how long, and then drive me back home.
“Ask a co-worker” - most of them still telework, and even at that, few of them live anywhere near me, so they would have to go seriously out of their way.
On top of that, even though I know this is an option, I have never been given the option of a local anesthetic.
Mine’s coming up in 4 days - second time around. Off to pick up the jug, the Peglyte, and some of that horrible liquid diet stuff. My roommate is buggering off to her boyfriend’s place for the evening of prep - wise, considering there’s only one bathroom chez nous.
I’m sorry to rub it in, but the whole thing is covered by the Ontario Health Insurance Plan (OHIP), regardless of what they do or do not find up there. Hoping the US can figure out universal health care in the near future.
Looking forward to the stupendous farts post-op!
If they’ve upgraded to CO2, you might not get that. 
WHAT?!? Even that tiny sliver of pleasure must be removed? I’m heart broken!
We had a near miss at the church I worked at for a few years - we had scheduled a Celtic Vespers service for the evening when the Senior Minister had his colonoscopy schedule. The church secretary caught it in time, and rescheduled his colonoscopy. I was not the only one who thought it would be fantastic if he’d gone through with it, and dropped some cassock-inflating steamers in the middle of the service…
Disappointingly, I’ve only once or twice had loud farts after my procedures.
Considering this last one, it’s as well since things were, er, still happening.
On the “liquid diet”: do you by any chance have a pho restaurant near you? (vietnamese noodle soup). I always get 2 or 3 quarts of plain broth, just before my procedures. as it’s nice to have something warm to drink.
That’s a beezer idea! There aren’t any vegetarian Pho places nearby - the broth is usually beef, chicken, and/or fish based, but! Thing One and I can make some mushroom-garlic broth over the weekend! Thanks for the brilliant suggestion!
Are you vegetarian? I was allowed to eat clear meat broth as part of my “clear liquid diet”.