CPT® Code 45315

Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique

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 multiple tumors, polyps, or other lesions utilizing techniques such as hot biopsy forceps, bipolar cautery, or snare technique. 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. Once the obturator is removed, the eyepiece is attached to the scope, allowing for visualization. The scope is advanced further into the rectum, aided by air insufflation to separate the mucosal folds for better visibility. The scope is then maneuvered to the rectosigmoid junction and, if feasible, into the sigmoid colon. After thorough inspection of the mucosa, any identified tumors, polyps, or lesions can be addressed. The hot biopsy forceps method involves the use of insulated monopolar forceps that simultaneously remove and cauterize tissue, while bipolar cautery employs electrical current between two points on the forceps to achieve similar results. The snare technique involves placing a wire loop around the lesion, which is then heated to excise and cauterize the tissue. This procedure is particularly effective for the removal of multiple lesions, ensuring that patients receive comprehensive treatment during a single session.