Looking for help with preventative colonoscopy screening

[u/Subject_Narwhal_6072]

So I visited my PCP looking for a referral due to an extensive family history of Colon Cancer (both of my parents were screened and had polyps removed, my Paternal aunt was diagnosed with stage 3 colon cancer at age 40 and died shortly after. Other paternal aunt had polyps removed too. So I pushed my doctor with this information to give a referral for a preventative screening colonoscopy at an earlier age. Was referred to the GI place and did a consultation there. I was able to get a pre auth from insurance but it was mis-coded as a Diagnostic. I was hoping that due to my family history that I could get this as a preventative screening so I could have peace of mind. A friend of my girlfriend's had recently passed away from surprise colon cancer too in her early 40s so I was extremely on edge. I could use any advice or help with writing a letter to my PCP and the GI Doc to help get this coded as a preventative screen even though I am only 36, I feel like I am a high-risk individual due to my familiy history.

Any help would be appreciated with how I can write a letter or what I can say to help my case in getting this coded correctly for insurance. Thanks!

[u/Mountain-Arm6558951]

Writing a letter to your PCP would do no good as that is not the provider who did the procedure.

Most carriers use the United States Preventive Services Task Force guidelines for individuals at risk of colorectal cancer begin screening at age 45. Under 45 would be consider a diagnostic.

Adults aged 45 to 49 years

The USPSTF recommends screening for colorectal cancer in adults aged 45 to 49 years.

Source

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

I would recommend checking your carriers medical guidelines on preventative colonoscopes.