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A colonoscopy through stoma is a specialized procedure that involves the examination of the colon via an existing stoma, which is an opening created surgically to allow waste to exit the body. This procedure is particularly significant for patients who have undergone colostomy or ileostomy surgeries. During the colonoscopy, the physician utilizes an endoscope, a flexible tube equipped with a camera and light, which is inserted through the stoma. The primary objective of this procedure is to inspect the mucosal surfaces of the colon for any abnormalities, such as polyps, tumors, or signs of inflammation. In addition to diagnostic purposes, this procedure also focuses on controlling any active bleeding that may be present. Various methods can be employed to achieve hemostasis, including thermal modalities like bipolar or unipolar cautery, which apply heat to the bleeding site, or the use of a heater probe. Furthermore, injectable agents such as epinephrine may be administered to constrict blood vessels and assist in stopping the bleeding. Advanced techniques, such as YAG laser coagulation and argon plasma coagulation, are also available for noncontact coagulation of the bleeding site. In cases where there are tears or lacerations, mechanical methods such as staples or hemoclips may be utilized to bring the tissue edges together, promoting healing and further controlling bleeding.
© Copyright 2025 Coding Ahead. All rights reserved.
The colonoscopy through stoma is indicated for various clinical scenarios where direct visualization and intervention in the colon are necessary. The following conditions may warrant this procedure:
The colonoscopy through stoma involves several critical procedural steps to ensure effective examination and treatment. The following outlines the key steps involved:
After the colonoscopy through stoma, the patient is monitored for any immediate complications, particularly related to bleeding or perforation. Post-procedure care includes ensuring the patient is stable and recovering from sedation. The physician may provide specific instructions regarding diet, activity level, and signs of complications to watch for, such as increased abdominal pain or changes in stoma output. Follow-up appointments may be scheduled to discuss findings from the procedure and any necessary further interventions or treatments.
| Short Descr | COLONOSCOPY FOR BLEEDING | Medium Descr | COLONOSCOPY STOMA CONTROL BLEEDING | Long Descr | Colonoscopy through stoma; with control of bleeding, any method | 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 payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - 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 | 44388 Colonoscopy through stoma; 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 | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8D - Endoscopy - colonoscopy | MUE | 1 | CCS Clinical Classification | 76 - Colonoscopy and biopsy |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2015-01-01 | Changed | Description Changed |
| 2002-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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