CPT® Code 45389

Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)

A flexible colonoscopy is a diagnostic and therapeutic procedure that involves the use of a flexible tube equipped with a camera, known as a colonoscope, to visualize the interior of the colon. This procedure is specifically performed to place an endoscopic stent, which is a tube-like device used to keep a narrowed segment of the colon open. The process begins with the introduction of the colonoscope into the anus and its advancement through the rectum into the colon. During this journey, air is insufflated to separate the mucosal folds, enhancing the visualization of the colon's lining. Once the colonoscope reaches the area of stenosis, or narrowing, the physician assesses the position and length of the stricture. If the stricture requires pre-dilation, a guidewire is inserted through the colonoscope, followed by the passage of a series of rigid tubes of increasing diameter over the guidewire to dilate the narrowed segment. Alternatively, a balloon catheter may be utilized, which is advanced to the stricture site and inflated to achieve dilation. Following the dilation, the stent placement is performed. A guidewire is again passed through the colonoscope, and the stent delivery system is introduced over the guidewire and positioned within the narrowed area of the colon. The physician selects an appropriately sized stent, which is then deployed in the stricture. To ensure proper placement and function, a balloon catheter may be inserted and inflated to secure the stent in place. Finally, the endoscope is advanced through the stent to confirm its correct positioning and proper deployment before the scope is withdrawn from the colon.