News from the AGA

Closing the colonoscopy loophole


What is the colonoscopy loophole?

The Affordable Care Act covers screening colonoscopies at no cost to patients as long as no polyps are found. As Dr. Siddique explains in her article, finding a polyp changes the billing code to a therapeutic colonoscopy, a reclassification that changes the procedure from a diagnostic screening to an intervention. And this means a bill is generated. This reclassification directly affects those covered by Medicare and not commercial insurers.

AGA leaders urge Congress to correct this problem

Dr. Siddique – a member of the AGA Trainee and Early Career Committee and AGA Clinical Guidelines Committee – joined other AGA leaders for AGA Advocacy Day in late September where they spoke directly to lawmakers about patients who are blindsided by this regulation. AGA supports closing this loophole to ensure patients continue to have access to quality care and preventative screenings. We encourage all members to continue to share their patient stories, like Dr. Siddique has, to help raise awareness of this issue.

AGA can help you advocate for GI

Watch an AGA webinar at (login required) to learn more about how to set up congressional meetings in your district, or contact Navneet Buttar, AGA government and political affairs manager, at or 240-482-3221.

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