Alabama Blue Cross
Considered experimental unless used as an alternative when an instrument colonoscopy of entire colon is incomplete due to obstructive or stenosing colonic lesions resulting in inability to pass colonoscope proximally.
+  more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
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Medicare:
Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07)
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare:
Upstate New York - HealthNow — Only indicated in patients in whom instrument colonoscopy is incomplete due to inability to pass colonoscope proximally. Not reimbursable for screening or in absence of signs of disease.
Downstate (excluding Queens) - Empire HealthChoice Assurance (now part of National Government Services) — Only indicated in patients in whom instrument colonoscopy is incomplete due to inability to pass colonoscope proximally. Not reimbursable for screening or in absence of signs of disease.
+ more
Queens - GHI — Only indicated in patients in whom instrument colonoscopy is incomplete due to inability to pass colonoscope proximally. Not reimbursable for screening or in absence of signs of disease.
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07)
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Empire Blue Cross/Wellpoint (downstate NY)
For screening it is considered medically necessary as alternative to colonoscopy when patient is unable to undergo colonoscopy for technical reasons and patient is at higher than average risk for colorectal cancer based on: family history; or prior history of adenomatous polyps; or personal history of resected colorectal cancer; or older unscreened relativeswith newly diagnosed FAP with no genetic evidence or clinical manifestations; or patients with genetic or clinical diagnosis of HNPCC; or inflammatory bowel disease. For Diagnosis it is considered medically necessary as alternative to colonoscopy in following conditions: for examination of colon proximal to distant obstructing lesion which prevents passage of colonoscope to rule out synchronous cancers; or where it can not performed due to techical inability to visualize colon, or patient unable to tolerate colonoscopy or sedation for medical reasons and other testing has been negative.
+ more
Excellus Blue Cross (Upstate NY)
Considered medically appropriate for either diagnosis or screening as follows: in patients in whom a conventional colonoscopy is incomplete or in patients with concurrent medical conditions for whom conventional colonoscopy is contraindicated.
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
Medicare: Noridian — Covered only in patients having qualifying conditions: instrument colonoscoopy is incomplete and/or contraindicated due to obstruction; coagulopathy; lifetime or long-term anticoagulation therapy with increased patient risk if discontinued; or significant medical or surgical complicatins from previous standard colonoscopy. Screening not reimbursable (0066T).
+ more
Commercial Payers:
Aetna
Considered medically necessary for colonic evaluation of symptomatic members with known colonic obstruction or incomplete colonoscopy to obstructive or stenosing lesions or for members receiving chronic anticoagulation that can’t be interrupted. Experimental for all other indications (10/5/07).
+ more
Cigna
Considered medically necessary in individuals with a colonic mass for CRC diagnosis or for surveillance when either of following are met: when conventional colonoscopy can't be completed due to known lesion, abnormality or technical difficulty that presents adequate visualization or when criteria for conventional colonoscopy have been met and it is contraindicated.
+ more
Humana
Covered only as an alternative to traditional colonoscopy when patient is unable to complete or undergo traditional colonoscopy due to known obstruction. All other indications considered experimental.
+ more
United Healthcare
Covered as a diagnostic tool for syptomatic patients who are unable to undergo complete colonoscopy. Not covered as screening tool.
+ more
Back to top
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