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A rectal stricture refers to the abnormal narrowing of a segment of the rectum, which can significantly impact bowel function and overall health. This condition may arise from various causes, including inflammation, trauma, or injury to the rectal area. Such injuries can result from previous surgical procedures, radiation therapy, or other forms of trauma, leading to the formation of scar tissue. This scar tissue can contract over time, resulting in the constriction of the rectal passage. The procedure associated with CPT® Code 45150 involves a transanal approach to address this issue. During the procedure, the surgeon identifies the narrowed segment of the rectum, incises the rectal wall, and carefully divides the contracted tissue. Importantly, the surgical site is left open to heal by secondary intention, allowing for natural healing processes to occur without the need for sutures. This method aims to restore normal rectal function and alleviate symptoms associated with the stricture.
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Rectal strictures may necessitate surgical intervention for various reasons, primarily to alleviate symptoms and restore normal bowel function. The following conditions are explicitly indicated for the procedure associated with CPT® Code 45150:
The procedure for the division of a rectal stricture involves several critical steps, each aimed at effectively addressing the narrowed segment of the rectum. The following procedural steps are outlined:
After the procedure, patients can expect a recovery period during which the rectum heals naturally. Post-procedure care may include monitoring for any signs of infection or complications, as well as managing pain and discomfort. Patients are typically advised on dietary modifications to ease bowel movements and may require follow-up appointments to assess healing progress. It is important for patients to adhere to any specific instructions provided by their healthcare provider to ensure optimal recovery and prevent recurrence of strictures.
| Short Descr | EXCISION OF RECTAL STRICTURE | Medium Descr | DIVISION STRICTURE RECTUM | Long Descr | Division of stricture of rectum | 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) | 0 - 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. | 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 96 - Other OR lower GI therapeutic procedures |
| 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). | 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.) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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