CPT® Code 45345

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A flexible sigmoidoscopy is a diagnostic and therapeutic procedure that involves the use of a flexible tube equipped with a light and camera, known as a sigmoidoscope. This procedure allows for direct visualization of the sigmoid colon and rectum. In the context of CPT® Code 45345, the procedure is specifically performed with the additional step of transendoscopic stent placement, which includes the process of predilation. The primary purpose of this intervention is to address intestinal obstructions that are often caused by malignant neoplasms, which are abnormal growths that can lead to blockages in the bowel. During the procedure, the sigmoidoscope is carefully inserted through the anus and advanced through the rectum into the sigmoid colon, reaching the site of the obstruction. The mucosal lining of the colon is meticulously examined for any signs of ischemia, which is a reduction in blood flow, or necrosis, which refers to tissue death. If the mucosa appears to be intact and healthy, a guide wire is introduced through the sigmoidoscope and navigated across the obstructed area. Should the obstruction require it, a balloon catheter is utilized for predilation, which involves inflating the balloon to widen the stricture before the stent is placed. Following this, an appropriately sized stent is selected and positioned over the guide wire, and it is deployed under direct endoscopic visualization. The procedure concludes with the removal of the sigmoidoscope, having successfully placed the stent to alleviate the obstruction.