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Excision of rectal procidentia, with anastomosis, is a surgical procedure designated by CPT® Code 45135. This procedure addresses rectal procidentia, which is characterized by a complete prolapse of the rectum, where the entire thickness of the rectal wall protrudes through the anal opening. The surgical intervention involves a combined approach, utilizing both abdominal and perineal techniques to effectively remove the prolapsed rectum and restore normal anatomy. The procedure is essential for patients suffering from this condition, as it alleviates symptoms associated with rectal prolapse, such as discomfort, incontinence, and potential complications from the prolapse itself. The operation is performed under general anesthesia, and the patient is typically positioned in lithotomy to facilitate access to the perineum and abdominal cavity. The complexity of the procedure requires careful dissection and mobilization of the rectum and surrounding structures to ensure successful excision and anastomosis, ultimately aiming to preserve the function of the anal mucosa and maintain bowel continuity.
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The excision of rectal procidentia with anastomosis is indicated for patients presenting with the following conditions:
The procedure for excision of rectal procidentia with anastomosis involves several critical steps:
Post-procedure care for patients undergoing excision of rectal procidentia with anastomosis includes monitoring for any signs of complications such as infection, bleeding, or anastomotic leakage. Patients are typically advised to follow a specific diet to ease bowel movements and may require pain management strategies. Follow-up appointments are essential to assess healing and ensure that the anastomosis is functioning properly. Patients may also receive guidance on pelvic floor exercises to aid in recovery and improve bowel function.
| Short Descr | EXCISION OF RECTAL PROLAPSE | Medium Descr | EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH | Long Descr | Excision of rectal procidentia, with anastomosis; abdominal and perineal approach | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 78 - Colorectal resection |
| 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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