Our gastroenterologist standard of care encourages patients to use deep sedation anesthesia services for any endoscopy procedures. Doing so will likely result in both the procedure and recovery being more comfortable for you. We do want you to be aware that you will receive a separate bill for these services.
We understand that the actual procedure may be a preventative or wellness screening which is covered by most insurance payers at 100% but deep sedation or anesthesia for this procedure may still not be covered. We strongly suggest that you fully understand your plan coverage before the services are performed and obtain any pre-authorizations needed so you are fully prepared for any balance that is your responsibility. Please be aware that some health care policies have determined that anesthesia services (deep sedation) for a colonoscopy is covered only under strict pre-determined medically necessary circumstances.
If you are uninsured, please contact Missoula Anesthesiology at (406) 728-8420 to receive an estimate or to make payment arrangements. If you are interested in receiving an estimate for your anesthesia services, please be sure to ask you gastroenterologist for the CPT code and the length of the endoscopy procedure before you call the Missoula Anesthesiology office.
Missoula Anesthesiology is contracted for Medicare, MT and ID Medicaid, the various Veteran Administration contracts, Blue Cross Blue Shield of Montana (see your Blue Cross handbook for specific programs), Pacific Source, and Cigna/Allegiance Benefit Plans. FOr these providers and all other insurance policies, please understand that Missoula Anesthesiology cannot randomly adjust your balance after your insurance pays. Each insurance company determines allowed amounts for each procedure individually. The amount they choose to cover is based on numerous factors and wide geographical areas that may or may not veary for average retail rates. Our experience is that there can often be large discrepancies between insurance plans.
Colonoscopy: Screening or Diagnostic
Diagnostic/Therapeutic Colonoscopy: Patient has past and or present gastrointestinal symptoms, polyps, GI disease, iron deficiency anemias, and or any other abnormal tests. Any colonoscopy that follows a positive Cologuard or FIT test is considered a diagnostic colonoscopy.
Surveillance/High Risk Screening Colonoscopy: Patient is asymptomatic (no gastrointestinal symptoms either past or present) has a personal history of GI disease, personal and or family history of colon polyps, and or cancer. Patients in this category are required to undergo colonoscopy surveillance at shortened intervals (e.g., every 2-5 years)
Preventative Colonoscopy Screening Diagnosis: Patient is asymptomatic (no gastrointestinal symptoms either past or present), over the age of 50, has no personal or family history of GI disease, colon polyps, and or cancer. The patient has not undergone a colonoscopy within the last 10 years.
Types of Sedation During a Colonoscopy
There are 2 types of sedation that can be used during a Colonoscopy and EGD
1) Conscious Sedation
2) Monitored Anesthesia Care
Conscious Sedation - A nurse will administer the sedation under the direction of a physician
Up until a few years ago, conscious sedation was the most commonly used form of sedation during a colonoscopy and EGD. The sedation, usually a mixture of Fentanyl & Versed, is administered to the patient via an IV. As the name suggests, you will be heavily sedated but conscious and will be able to somewhat respond to verbal stimulation. Depending on the individual, the sedation could take up to several hours to wear off after the procedure. The facility will usually keep you in a recovery bay until they determine enough of the sedation has worn off for you to leave the premises safely. You will be required to have someone pick you up from the facility and ensure that you reach home safely. You will not be allowed to operate a vehicle or any machinery that day.
Monitored Anesthesia Care (MAC) - An Anesthesiologist will administer this sedation
MAC stands for Monitored Anesthesia Care and is another form of sedation. In the past few years, it has gained wide acceptance and become the standard of care for colonoscopy and EGD procedures.
With MAC, you will be put to sleep and will be deeply sedated. However, you will be able to breathe on your own without the need of a ventilator or breathing tube.
MAC commonly uses the drug Propofol and is administered to the patient via an IV. This type of anesthesia gives comfort and amnesia to patients that are anxious and gives the advantage of a much quicker recovery than conscious sedation. The patient recovers from the induced sleep almost instantly after medication is stopped and a large part of the effects of the drug wear off in less than 20 minutes. The quick recovery time, is one of the reasons why MAC anesthesia has become so popular. Even with the quick recovery time, patients will still need someone to pick them up and ensure that they get home safely. You will not be allowed to drive or operate heavy machinery for the rest of the day.