CPT® Code 45317

Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)

A rigid proctosigmoidoscopy is a diagnostic and therapeutic procedure that involves the examination of the rectum and the lower part of the sigmoid colon. This procedure is performed using a rigid scope, which is a tubular instrument designed to visualize the interior of the rectum and sigmoid area. The primary purpose of this procedure is to control bleeding that may occur in these regions. During the procedure, various techniques can be employed to manage bleeding, including the use of injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, or plasma coagulator. The process begins with the insertion of an obturator 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 to allow for visualization. Air is insufflated to separate the mucosal folds, facilitating a clearer view of the rectal and sigmoid mucosa. The scope is advanced to the rectosigmoid junction and, if feasible, into the sigmoid colon. Once the examination is complete, the scope is withdrawn, and the mucosa is carefully inspected for any signs of bleeding. If a bleeding site is identified, various methods can be employed to control the bleeding, such as applying heat through cautery devices or using injections to promote vasoconstriction. This procedure is essential for managing acute bleeding in the lower gastrointestinal tract and can help prevent further complications.