Colonoscopy Guidelines

Colonoscopy is covered for average‑risk CRC screening every 10 years from age 45 to 85, for earlier/more frequent high‑risk and genetic‑syndrome screening, post‑polypectomy and post‑cancer surveillance, IBD assessment, and therapeutic/endoscopic resections, but is generally not indicated for isolated constipation or abdominal pain without alarm features, acute diarrhea in immunocompetent persons (with limited exceptions), or when results will not alter management. Key requirements include recent pertinent clinical evaluation (within 60 days, in‑person or telehealth), supporting labs/imaging/pathology and prior procedure reports (including BBPS bowel‑prep documentation), and adherence to specified surveillance intervals based on polyp number/size/histology and resection method (e.g., 1–2 tubular adenomas <10 mm: 7–10 years; ≥10 adenomas: 1 year; piecemeal resection ≥20 mm: 6 months).

""Average-risk" is defined as an asymptomatic individual with no previously diagnosed: Colorectal cancer; Colonic adenomas; Inflammatory bowel disease involving the colon" — Colonoscopy every 10 yea..."