CPT® Code 45308

A rigid proctosigmoidoscopy is a diagnostic and therapeutic procedure that involves the examination of the rectum and the lower part of the colon (sigmoid colon) using a rigid scope. This procedure is specifically designed for the removal of a single tumor, polyp, or other lesion utilizing hot biopsy forceps or bipolar cautery. The term "proctosigmoidoscopy" refers to the combination of proctoscopy, which examines the rectum, and sigmoidoscopy, which examines the sigmoid colon. During the procedure, an obturator is inserted into the scope, which is then introduced into the anus and advanced approximately 5 centimeters into the rectum. After the obturator is removed, the eyepiece is attached, allowing for visualization. The scope is advanced further into the rectum, utilizing air insufflation to separate the mucosal folds for better visibility. The procedure aims to reach the rectosigmoid junction and, if feasible, a short distance into the sigmoid colon. Once the scope is withdrawn, the mucosa is carefully inspected to identify any tumors, polyps, or lesions present. In the context of CPT® Code 45308, the removal of the identified lesion is performed using either hot biopsy forceps or bipolar cautery. The hot biopsy technique employs insulated monopolar forceps that simultaneously remove and cauterize tissue, while bipolar cautery utilizes electrical current between two points on the forceps to achieve the same effect. These methods are particularly effective for small polyps and vascular ectasias. This procedure is essential for both diagnostic purposes and therapeutic interventions in managing colorectal lesions.