CPT® Code 44388

Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

A colonoscopy through a stoma is a specialized procedure that involves the examination of the colon via an existing stoma, such as a colostomy. This procedure is primarily diagnostic in nature and may include the collection of specimens through techniques such as brushing or washing. During the colonoscopy, a colonoscope—a flexible tube equipped with a camera and light—is inserted through the stoma and advanced through the colon. The physician inspects the mucosal surfaces of the colon for any abnormalities, which may include ulcerations, varices, bleeding sites, lesions, strictures, or other pathological conditions. After the initial inspection, the endoscope is withdrawn, allowing for a second evaluation of the mucosal surfaces. In addition to visual inspection, the procedure may involve obtaining cytology samples. This is accomplished by introducing a brush through the endoscope to collect cell samples from the mucosal lining. Alternatively, sterile water can be used to wash the mucosal surfaces, and the aspirated fluid can be analyzed for cellular content. If any suspicious areas are identified during the examination, the procedure may be extended to include biopsies. This involves the use of biopsy forceps that are inserted through the endoscope to capture tissue samples from the identified sites. The collected samples, whether they are cytology or biopsy specimens, are then sent for laboratory analysis, which is reported separately. This comprehensive approach allows for thorough evaluation and diagnosis of potential gastrointestinal issues in patients with a stoma.