I think you have to reach in and undo the oil pickup to get the pan off in frame. Once you've got it off, replacing rod and main bearings is pretty easy and relatively cheap. Use a mirror to look on top of the crank and check the cooling nozzles. If any of them are missing or plugged, a scored cylinder is likely.
My 01 has a knock (see thread
https://www.turbodieselregister.com/forums/showthread.php?t=158071), but I'm still driving it. When they pulled the pan and rotated the crank, they couldn't see high enough in the cylinder to see any scoring. I'd have to pull the head to be certain. The knock on mine goes away if I crack the #5 injector, and it lessens considerably once the truck warms up. The mechanics and service manager at the local Cummins shop told me to drive it 'til it drops because I'd probably be sleeving it anyways. Evan Beck (see thread above) says if it's only slightly scored, it can be honed in frame. I think if I were going to go to that extent, I'd pull it and go for a complete rebuild or a new drop in.
Aside from the knock, it runs great.
And it's for sale...