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A rigid proctosigmoidoscopy is a diagnostic and therapeutic procedure that involves the examination of the rectum and the lower part of the colon (sigmoid) using a rigid scope. This procedure is specifically performed when there is a need to remove a foreign body that has become lodged within the rectum. The process begins with the insertion of an obturator into the proctosigmoidoscope, which is then introduced into the anus and advanced approximately 5 centimeters into the rectal cavity. Once the obturator is removed, the eyepiece is attached to the scope, allowing for visualization. The scope is further advanced to the location of the foreign body. In cases where the foreign body has smooth edges, a balloon catheter may be utilized to facilitate its removal. The catheter is maneuvered past the foreign body, and upon inflation of the balloon, it creates a grip on the object, allowing for its withdrawal from the rectum. For foreign bodies that are impacted, forceps are introduced through the endoscope to grasp and extract the object. After the foreign body is successfully removed, the endoscope is reinserted to conduct a thorough examination of the rectum, checking for any signs of perforation or other injuries that may have occurred during the process. This procedure is critical for addressing obstructions and ensuring the integrity of the rectal and colonic tissues.
© Copyright 2025 Coding Ahead. All rights reserved.
The rigid proctosigmoidoscopy with removal of a foreign body is indicated in specific clinical scenarios where a foreign object has been introduced into the rectum and requires extraction. The following conditions may warrant this procedure:
The procedure for performing a rigid proctosigmoidoscopy with removal of a foreign body involves several critical steps to ensure effective and safe extraction of the object. The following outlines the procedural steps:
After the completion of the rigid proctosigmoidoscopy and the removal of the foreign body, the patient may be monitored for any immediate complications. It is essential to assess for signs of rectal bleeding, perforation, or infection. The patient may experience some discomfort or cramping following the procedure, which is typically manageable. Instructions regarding post-procedure care, including dietary recommendations and activity restrictions, should be provided to the patient. Follow-up appointments may be necessary to ensure proper healing and to address any ongoing concerns related to the procedure.
| Short Descr | PROCTOSIGMOIDOSCOPY FB | Medium Descr | PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY | Long Descr | Proctosigmoidoscopy, rigid; with removal of foreign body | 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) | 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. | Endoscopic Base Code | 45300 Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (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 | 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) | P8C - Endoscopy - sigmoidoscopy | MUE | 1 | CCS Clinical Classification | 229 - Nonoperative removal of foreign body |
| 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). | 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. | 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.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| Pre-1990 | Added | Code added. |
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