CPT® Code 44402

Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)

A colonoscopy through stoma is a specialized procedure that involves the examination of the colon via an existing stoma, which is an opening created surgically to allow waste to exit the body. This procedure is particularly relevant for patients who have undergone colostomy or ileostomy surgeries. During the colonoscopy, a flexible tube known as a colonoscope is inserted through the stoma to inspect the mucosal surfaces of the colon, extending from the stoma to the cecum or the small intestine proximal to an anastomosis. The primary goal of this procedure is to identify any abnormalities within the colon, such as polyps, tumors, or areas of inflammation. In addition to the inspection, this procedure includes the placement of an endoscopic stent, which is a tube-like device used to keep a narrowed segment of the colon open. The process involves pre-dilation and post-dilation of the stricture, which is the narrowed area of the colon, to facilitate the placement of the stent. Pre-dilation may involve the use of a guidewire and a series of rigid tubes or a balloon catheter to expand the stricture. Once the area is adequately prepared, the stent is positioned and deployed to ensure that the narrowed segment remains open, allowing for improved passage of stool and reducing the risk of obstruction. The entire procedure is performed under careful monitoring, and the colonoscope is used to verify the correct placement of the stent before withdrawal.