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Perirectal injection of sclerosing solution for prolapse, as described by CPT® Code 45520, is a medical procedure aimed at addressing rectal prolapse, which can manifest in two forms: partial and complete. Partial rectal prolapse is characterized by the protrusion of only the rectal mucosa through the anus, while complete rectal prolapse involves the protrusion of a portion of the entire thickness of the rectum. The primary objective of this procedure is to treat partial prolapse effectively. During the procedure, a sclerosing solution, which may include agents such as saline, alcohol, or phenol, is prepared for injection. To ensure accurate placement of the needle tip, a gloved finger may be inserted into the rectum, providing tactile guidance. The sclerosing solution is then infiltrated into the perirectal tissue, specifically targeting the lateral and posterior areas, to promote tissue adhesion and reduce the prolapse. This method is a minimally invasive approach that aims to alleviate the symptoms associated with rectal prolapse and improve the patient's quality of life.
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The procedure of perirectal injection of sclerosing solution for prolapse is indicated for the treatment of rectal prolapse, particularly in cases where the prolapse is partial. The following conditions may warrant this procedure:
The procedure involves several key steps to ensure effective treatment of the rectal prolapse. The following outlines the procedural steps:
After the perirectal injection of sclerosing solution, patients may be monitored for any immediate reactions to the procedure. It is important to assess the injection site for any signs of complications, such as infection or excessive bleeding. Patients may experience some discomfort or mild pain following the procedure, which can typically be managed with over-the-counter pain relief. Follow-up appointments may be scheduled to evaluate the effectiveness of the treatment and to determine if additional interventions are necessary. Overall, the recovery process is generally straightforward, with most patients able to resume normal activities shortly after the procedure.
| Short Descr | TREATMENT OF RECTAL PROLAPSE | Medium Descr | PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE | Long Descr | Perirectal injection of sclerosing solution for prolapse | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | 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) | 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. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 98 - Other non-OR gastrointestinal 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). | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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. |
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