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A flexible sigmoidoscopy is a diagnostic and therapeutic procedure that involves the examination of the sigmoid colon using a flexible endoscope. This procedure is specifically designed for the ablation of tumors, polyps, or other lesions that cannot be removed using traditional methods such as hot biopsy forceps, bipolar cautery, or snare techniques. During the procedure, a standard flexible sigmoidoscope is inserted into the anus and advanced through the rectum into the sigmoid colon. Air insufflation is utilized to expand the colon and separate the mucosal folds, allowing for a clear view of the internal structures. Once the scope is in place, it is withdrawn to inspect the mucosa carefully. If any tumors, polyps, or lesions are identified, they can be treated accordingly. In cases where lesions are amenable to removal, a snare technique may be employed, as described in CPT® Code 45338. However, for lesions that require ablation, CPT® Code 45339 is utilized, which involves the use of alternative techniques such as laser ablation. In this method, a laser device is introduced through the endoscope and directed at the lesion, starting from the proximal margin and moving along the entire lesion to effectively destroy it.
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The procedure is indicated for the following conditions:
The procedure involves several key steps to ensure effective examination and treatment of the sigmoid colon.
After the procedure, the patient may be monitored for any immediate complications or adverse reactions. It is important to provide post-procedure care instructions, which may include dietary recommendations and activity restrictions. Patients should be informed about potential symptoms to watch for, such as bleeding or severe abdominal pain, and advised to contact their healthcare provider if these occur. Follow-up appointments may be scheduled to assess recovery and discuss any further treatment options if necessary.
| Short Descr | SIGMOIDOSCOPY W/ABLATE TUMR | Medium Descr | SIGMOIDOSCOPY FLX ABLTJ LESION | Long Descr | Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special rules for multiple endoscopic procedures apply... | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 9 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 45330 Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Multiple Reduction Applies | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8C - Endoscopy - sigmoidoscopy | MUE | Not applicable/unspecified. | CCS Clinical Classification | 77 - Proctoscopy and anorectal biopsy |
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| 2015-01-01 | Deleted | Code deleted, see 45346 |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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