CPT® Code 45335

A flexible sigmoidoscopy is a diagnostic procedure that involves the use of a flexible tube equipped with a light and camera, known as a sigmoidoscope, to examine the lower part of the colon, specifically the sigmoid colon and rectum. During this procedure, directed submucosal injections of any substance are administered to enhance visualization and facilitate further interventions if necessary. Common substances used for these injections include India ink, saline, epinephrine, or corticosteroids. India ink is particularly useful for marking lesions, a technique often referred to as tattooing, which aids in the identification of these areas for potential excision in subsequent procedures. Saline or epinephrine injections serve to create a submucosal fluid cushion, effectively separating the mucosal layer from the underlying muscle layer of the colon, thereby elevating the lesion for better access and visibility. The procedure begins with the introduction of the sigmoidoscope into the anus, which is then carefully advanced through the rectum and into the sigmoid colon. Air insufflation is utilized to expand the colon and separate the mucosal folds, allowing for a thorough inspection. After the scope is withdrawn, the mucosal surfaces are meticulously examined for any signs of abnormalities such as ulcerations, varices, bleeding sites, lesions, or strictures, ensuring a comprehensive assessment of the patient's condition.