Your health insurance policy will spell out exactly which screening tests are covered e.g. bone density testing, mammograms, PAP smears, so you will have to contact your insurance company to find out if they are covering virtual colonoscopy for colon cancer screening. Since this test is very new, insurance coverage is quite variable. In May of 2008, Virtual Colonoscopy was included in the joint guidelines for screening and surveillance for the early detection of colorectal cancers and polyps from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer and the American College of Radiology. Beginning at age 50, Virtual Colonoscopy every 5 years is now included as one of the recommended tests for average-risk individuals. Most insurers are covering Virtual Colonoscopy as medically necessary when conventional colonoscopy cannot be completed due to a known colonic lesion, a structural abnormality or a technical difficulty is encountered that prevents adequate visualization of the entire colon or when conventional colonoscopy is medically contraindicated. Medicare doses not yet provide coverage for virtual colonoscopy for colorectal cancer screening. Medicare still covers older screening tests such as barium enema or sigmoidoscopy for colon cancer screening screening. If you have a FLEX plan through your employer, you can use your FLEX benefit to pay for your virtual colonoscopy. If your physician refers you for your virtual colonoscopy and you obtain preauthorization from you health plan for your scan, Advanced Body Scan of Newport will submit a claim to your health insurance company on your behalf. You will be responsible for all co-pay’s and deductibles that apply. Advanced Body Scan of Newport is not a network provider for any managed care plan so out of network fee’s also apply. Our office manager will be happy to answer any questions and assist you with your FLEX benefit application for your Virtual Colonoscopy.
If your doctor orders these tests for diagnostic purposes and not for screening, then many insurance companies will pay for this exam. To assist your physician, we have prepared a form your physician can utilize to request benefits for you.
Yes, a cleansing bowel prep is necessary. Solid waste material must be purged from the colon before the exam as this material interferes with the ability to view the wall of the colon. If the prep is done incorrectly the exam may have to be repeated.
In general, there are two possible results from this exam. The best result is a clean exam in which no polyps or tumors are found. In our experience, this represents about 75% of our patient population. These people can be re-screened at 10 year intervals. Patients having overt cancers or polyps 10 mm or larger in size are referred for optical colonoscopy and biopsy. This is the case for 1-2% of our patients. Polyps 5 mm or smaller in size are generally not clinically important and re-screening for these individuals should not be done at more than 5 year intervals. People with polyps measuring 6-9 mm could opt for either optical colonoscopy with polypectomy or short-term surveillance virtual colonoscopy.
The electron beam scanner is by far the lowest radiation scanner available. A virtual colonoscopy done on an electron beam CT scanner exposes you to only about 800 mrem of radiation. This is approximately 3 times what you would receive in annual background radiation from natural causes. In contrast, multidetector CT (MDCT) delivers from 2,000 to 7,000 mrem depending on the protocol used. This is near the limit of the maximal annual dose of 5,000 mrem/yr recommended by the Health Physics Society.
This test requires the insertion of a small tube into the rectum and inflating the colon with air or carbon dioxide. This is much like having an enema. There are no needles or injections required and therefore it is non-invasive.
No. Since Virtual Colonoscopy is non-invasive, blood thinners are not a problem, as they are with conventional flexible colonoscopy.
Virtual Colonoscopy is very safe. There is no risk of colon perforation such as there is in a small percentage of cases with conventional flexible colonoscopy.
No. Virtual Colonoscopy does not require any sedation, pain medications, oral or IV medications. After the exam there is no observation or recovery period, and you can resume your regular daily activities.
Patients describe Virtual Colonoscopy as uncomfortable with mild cramping (but not painful) when the colon is being filled with air. If present, this cramping should last no more than 3 or 4 minutes. The CT scan can be completed in one or two breath holds and then the rectal tip is removed and the air is expelled or absorbed. The bloated feeling should pass within 30 minutes of completing the exam.
Virtual Colonoscopy has been shown to be as nearly as good as conventional colonoscopy in detecting clinically significant polyps and cancers in head to head trials. In fact, in some studies, Virtual Colonoscopy beat conventional colonoscopy in polyp detection because more of the colon was visualized. Conventional colonoscopy fails to visualize the entire colon in 10 to 20% of cases because the operator will be unable advance the scope to the end of the colon for technical reasons. A recent clinical trial conducted at Walter Reed Army Medical Center-Washington, D.C., National Navy Medical Center-Bethesda, MD and Navy Medical Center-San Diego, CA concluded that virtual colonoscopy is slightly more accurate than conventional colonoscopy in detecting significant colonic polyps. This study was published in the New England Journal of Medicine in 2003. 1,233 screening patients for colon cancer were recruited and each patient underwent first virtual colonoscopy and within two hours underwent optical colonoscopy to compare results. The study compared the percentage of polyps found by both virtual colonoscopy and optical colonoscopy. See chart below:

 

Polyp Size Threshold Virtual Colonoscopy Optical Colonoscopy
≥6 mm 88.70% 92.30%
≥8 mm 93.90% 91.50%
≥10 mm 93.80% 87.50%

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