CPT® Code 45341

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. This procedure is performed with the aid of an endoscopic ultrasound examination, which enhances the visualization of the intestinal wall and surrounding structures. During the procedure, the sigmoidoscope is carefully inserted into the anus and advanced through the rectum into the sigmoid colon. To facilitate this process, air is insufflated into the colon, which helps to separate the mucosal folds, allowing for a clearer view of the inner lining. Once the sigmoidoscope is in place, the physician withdraws it slowly while meticulously inspecting the mucosa for any abnormalities, such as polyps, tumors, or signs of inflammation. If any irregularities are detected, they are documented for further evaluation. Following the initial examination, an echoendoscope is introduced. This specialized instrument can be advanced further into the descending colon, providing a more comprehensive assessment. The echoendoscope is equipped with a transducer that is covered by a balloon filled with water, which aids in acoustic coupling for optimal ultrasound imaging. Continuous ultrasound imaging is conducted during this phase, allowing for the acquisition of detailed images that assist in evaluating any identified abnormalities. The primary purpose of echoendoscopy is to assess the depth of a tumor or lesion, determining whether it has penetrated beyond the mucosal layer into the submucosa or muscular wall of the colon, and to check for any involvement of adjacent organs or transmural spread. After a thorough evaluation of the tumor or lesion, the echoendoscope is carefully removed, concluding the procedure.