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A colonoscopy through a 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 indicated for patients experiencing pathologic distention of the colon, such as conditions like volvulus or megacolon. Volvulus refers to the twisting of the intestine around its mesenteric pedicle, leading to obstruction and the accumulation of feces and gas in a distended loop of intestine. This condition often arises in the sigmoid colon, especially in individuals with a history of long-standing constipation, resulting in an elongated and atonic colon, also known as acquired megacolon. If left untreated, volvulus can cause serious complications, including tissue infarction due to compromised blood supply and potential perforation, which can lead to peritonitis. During the colonoscopy, an endoscope is introduced through the colostomy opening, allowing for a thorough inspection of the mucosal surfaces of the colon from the stoma to the cecum. The procedure may involve air insufflation to separate mucosal folds for better visualization, and careful assessment for signs of ischemia or necrosis is conducted. If the mucosa appears healthy, a decompression tube may be placed to relieve the obstruction, facilitating the evacuation of backed-up feces and gas.
© Copyright 2025 Coding Ahead. All rights reserved.
The colonoscopy through stoma with decompression is indicated for specific conditions that lead to pathologic distention of the colon. These include:
The procedure involves several critical steps to ensure effective decompression and inspection of the colon. The following outlines the procedural steps:
Post-procedure care involves monitoring the patient for any signs of complications, such as infection or further obstruction. The decompression tube should remain in place for the specified duration to ensure effective relief of distention. Patients may require follow-up evaluations to assess bowel function and overall recovery. It is essential to provide instructions regarding signs of complications that should prompt immediate medical attention.
| Short Descr | COLONOSCOPY W/DECOMPRESSION | Medium Descr | COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION | Long Descr | Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, 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 | Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; 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. | 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). | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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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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