# How does the cost of Capsule Endoscopy compare?



## jimmyt1989

Hello all, just wondering if someone knows how the capsule endoscopy compares to a colonoscopy?  The reason I ask, is that I went for a second opinion and the 2nd GI suggested another colonoscopy.  I've had one of those and the first GI discovered an ulcer in my ileum.  The biopsy was neg for crohn's.  However, my mom has crohn's in the ileum and had two feet removed in that area a few years back.  I'm wondering if another colonoscopy would be a waste of time since they can only see the last part of the small intestine.  The 2nd GI was opposed to the capsule endo and quoted cost as the reason.  I quote "sir it's a waste of money".  Is it really that expensive?  I've met my out-of-pocket max since I've already had my gall bladder removed in Feb, which hasn't helped anything.  Excuse my french, but I don't give a crap about wasting the insurance company's money!  I want to figure out why I'm frequently fatigued, nauseated, and have diarrhea/constipation.  I want to know why I can barely make it through a full day at work, and why I don't feel good enough to go to church with my family tonight!!!!!!!!!!!!!!!!!!!!!!!


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## Mayflower537

Does that mean that you are fully covered?  Then why does this doc even care?  Lord knows, my doc hasn't brought that up once.    I hadn't met my deductible at the time I had the capsule, and they billed my insurance $2000.  But I ended up having to pay $1100 or something like that b/c that was the negotiated rate.  All things considered, the capsule was less than my colonoscopy b/c of the cost of biopsies, pathologist, anesthesiologist and whatever else they tacked on.   
Maybe he wants to get his own look at the ulcer in your ileum and the colonoscopy would be the best way to do that.  Someone correct me if I'm mistaken, but they have to biopsy the exact right spot in order for the pathology to come back positive.


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## jimmyt1989

Hi Mayflower,

Yep, I'm covered at 100% for the rest of this calendar year.  I'm trying to get them to do as many tests as possible before the year is up.

I'd be interested to hear what others on this board have to say about the biopsies.

One other thing, my endo just informed me that my vitamin d is borderline low.  That might be why I'm feeling fatigued and weak.  I'm wondering if is from malabsorption.

Anyway, thx and talk to you later.

Jimmy


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## bethany84

I can't comment on the cost of a capsule endoscopy as I live in the UK. However, I had one done, (actually in NZ at the time) and it was sooooo worth it! They couldn't find any active crohn's beforehand, despite the agony I was in and after every other procedure under the sun they decided to do a capsule endoscopy. (I think I became a bit of a pet project for the doc!) and what do you know...they found one hell of a mess in my small intestine that they never picked up any other way! The pictures were a fantastic confirmation for me that it wasn't in my head and there was a reason for my pain!

I hope you get it sorted for you and get piece of mind as to what the next move is for you. 

Keep us posted 
x


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## Mayflower537

Yeah, a lot of people on here were only diagnosed through the pillcam.  I would push for it, esp. since money is no object.


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## RachLG

Hi there Jimmy~  I had a capsule endo about 5 months ago and just got the payment settled....here's my words of caution.  I am very fortunate to have the best insurance my company offers, but when the doc suggested a pill cam, he told me he'd have his staff call my insurance first to make sure I was covered.  When I asked why, he said that some plans don't cover it unless it is "medically relevant" - why you would get one when it's not medically relevant, I'm not sure   But anyway, I got a call from his staff that my insurance would cover it so off I went to swallow the pill and be strapped to larger than I expected receiver.  A couple weeks after the procedure, I get a bill from the hospital that did the procedure (which is somewhat separate from the doctor's office) for $2500!!  So I called my doc and the staff said not to worry about it....however a month later I get a notice that the bill is on its way to collections, so obviously it's time to worry!  It's take 5 months of fighting with my insurance company and the hospital to prove that we checked that it would be covered prior to the test and that it was medically relevant (which finally was expressed by sending my entire medial file to the insurance).  My doc’s staff was wonderful in helping make phone calls and fighting for me, but it was NOT a fun process.  I would suggest you personally call your insurance and see what they say and get the name of the person you talk to.  I would suggest having the test though – it shows a whole lot more than a colonoscopy/upper endoscopy, particularly if you have inflammation at the end of the small bowel.  Good luck!


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## jimmyt1989

Thx all!  This is some excellent info!  You all are the best!

Jimmy


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