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A colonoscopy through stoma is a specialized procedure that involves the examination and treatment of the colon via an existing stoma, such as a colostomy. This procedure is primarily performed to ablate, or destroy, tumors, polyps, or other lesions found within the colon. During the colonoscopy, an endoscope is introduced through the stoma, allowing the physician to inspect the mucosal surfaces of the colon from the stoma to the cecum or a small intestine anastomosis. The procedure is comprehensive, as it includes not only the identification of abnormalities but also the potential for therapeutic interventions. If any lesions are detected, the physician may utilize techniques such as dilation to facilitate access for ablation. This may involve the insertion of a guidewire and the use of rigid tubes or a balloon catheter to expand the lumen of the large intestine. The ablation process typically employs a laser device, which is carefully maneuvered through the endoscope to target and destroy the lesions. The procedure is designed to ensure thorough examination and treatment, with careful monitoring to prevent any complications or injuries to the colon during the process.
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The colonoscopy through stoma procedure is indicated for the following conditions:
The colonoscopy through stoma procedure involves several critical steps to ensure effective examination and treatment of the colon.
After the colonoscopy through stoma procedure, patients may require monitoring for any immediate complications. It is essential to assess the colon for any signs of injury or adverse effects resulting from the ablation process. Patients may experience some discomfort or cramping following the procedure, which is typically managed with standard post-procedural care. Follow-up appointments may be necessary to evaluate the success of the ablation and to monitor for any recurrence of lesions. Documentation of the procedure and any findings is crucial for ongoing patient management and future reference.
| Short Descr | COLONOSCOPY WITH ABLATION | Medium Descr | COLONOSCOPY STOMA ABLATION LESION | Long Descr | Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed) | 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 | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P8D - Endoscopy - colonoscopy | MUE | 1 |
| 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2015-01-01 | Added | Added |
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