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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 relevant for patients who have undergone colostomy or ileostomy surgeries. During the colonoscopy, a flexible tube known as a colonoscope is inserted through the stoma to inspect the mucosal surfaces of the colon, extending from the stoma to the cecum or the small intestine proximal to an anastomosis. The primary goal of this procedure is to identify any abnormalities within the colon, such as polyps, tumors, or areas of inflammation. In addition to the inspection, this procedure includes the placement of an endoscopic stent, which is a tube-like device used to keep a narrowed segment of the colon open. The process involves pre-dilation and post-dilation of the stricture, which is the narrowed area of the colon, to facilitate the placement of the stent. Pre-dilation may involve the use of a guidewire and a series of rigid tubes or a balloon catheter to expand the stricture. Once the area is adequately prepared, the stent is positioned and deployed to ensure that the narrowed segment remains open, allowing for improved passage of stool and reducing the risk of obstruction. The entire procedure is performed under careful monitoring, and the colonoscope is used to verify the correct placement of the stent before withdrawal.
© Copyright 2025 Coding Ahead. All rights reserved.
The colonoscopy through stoma with endoscopic stent placement is indicated for various conditions that may lead to obstruction or narrowing of the colon. The following are explicitly provided indications for this procedure:
The procedure for colonoscopy through stoma with endoscopic stent placement involves several critical steps, each designed to ensure thorough examination and effective treatment of the narrowed segment of the colon. The following procedural steps are outlined:
After the colonoscopy through stoma with endoscopic stent placement, patients may require monitoring for any immediate complications, such as bleeding or perforation. It is essential to assess the patient's recovery and ensure that they are stable before discharge. Patients may experience some discomfort or cramping following the procedure, which is typically manageable with standard pain relief measures. Follow-up appointments are crucial to evaluate the effectiveness of the stent placement and to monitor for any potential complications or recurrence of symptoms. Additionally, patients should be educated on signs of complications, such as increased abdominal pain, fever, or changes in bowel habits, and advised to seek medical attention if these occur.
| Short Descr | COLONOSCOPY W/STENT PLCMT | Medium Descr | COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT | Long Descr | Colonoscopy through stoma; with endoscopic stent placement (including 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 | Hospital Part B services paid through a comprehensive APC | 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 |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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 | GW | Service not related to the hospice patient's terminal condition |
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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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