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Anoscopy with removal of a foreign body is a medical procedure that involves the visual inspection of the anus and rectum to identify and extract an object that has become lodged within the rectal cavity. This procedure typically begins with a digital rectal examination, which may be performed to assess the area and locate the foreign body. An anoscope, a tubular instrument designed for viewing the anal canal and lower rectum, is then utilized. The obturator, a device that facilitates the insertion of the anoscope, is placed into the scope before it is introduced into the anus. Once the anoscope is positioned at the site of the foreign body, the obturator is removed, and an eyepiece is attached to allow for direct visualization. In cases where the foreign body has smooth edges, a balloon catheter may be employed to assist in its removal. The catheter is advanced past the foreign body, and the balloon is inflated to create a seal around the object, allowing for its withdrawal. For more firmly impacted foreign bodies, forceps are used. These are passed through the endoscope to grasp the object securely before it is extracted. After the foreign body is removed, the endoscope is reinserted to conduct a thorough examination of the rectum, checking for any signs of perforation or injury that may have occurred during the process. This procedure is essential for addressing rectal obstructions and ensuring the integrity of the rectal wall following the removal of foreign objects.
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The procedure of anoscopy with removal of a foreign body is indicated for patients presenting with specific symptoms or conditions that suggest the presence of a foreign object in the rectum. These indications may include:
The procedure for anoscopy with removal of a foreign body involves several critical steps to ensure effective and safe extraction of the object. These steps include:
Following the completion of the anoscopy with removal of a foreign body, patients may require specific post-procedure care. It is essential to monitor for any signs of complications, such as rectal bleeding or pain, which may indicate injury to the rectal wall. Patients are typically advised to rest and may be instructed to avoid strenuous activities for a short period. Additionally, they should be informed about the signs of potential complications and when to seek further medical attention. A follow-up appointment may be scheduled to ensure proper healing and to address any ongoing concerns related to the procedure.
| Short Descr | ANOSCOPY REMOVE FOR BODY | Medium Descr | ANOSCOPY W/RMVL FOREIGN BODY | Long Descr | Anoscopy; 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) | 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 | 46600 Anoscopy; 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 | 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) | P8I - Endoscopy - other | MUE | 1 | CCS Clinical Classification | 229 - Nonoperative removal of foreign body |
| 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. | 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | 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 |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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