# High risk colon cancer screening



## lindacoder (Apr 27, 2012)

have not done enough scopes to feel comfortable with this scenario.

Patient has had two previous colon cancer resections including right and transverse colon who has just been diagnosed with Lynch syndrome and presents for screening for possible subtotal colectomy.

Patient was placed in the left lateral decubitus position. Monitored anesthetic care was delivered throughout the procedure. A digital rectal exam was performed and it revealed no masses. AThe colonoscopy wzs then advanced. The sigmoid colon and the entirety of the descending colon were difficult to navigate. This was eventually completed and the transverse colon was intubated. The scope was advanced the the anastomosis of small bowel to the transverse colon was identified. The small bowel could not be intubated The scope was then slowly withdrawn to fully evaluate the mucosa. The prep was found to be excellent. There were no masses or evidence of any recurrence at the anastomosis, There were no polyps throughout the entirety of the colon. There were a few scattered diverticula in the sigmoid colon. In the rectum the scope was retroflexed and there was found to be small internal hemorrhoids and no masses. The scope was then completely withdrawn after the rectum was desufflated. This then completed the procedure. A note is made that this was a very different colonoscopy and difficult to navigate the sigmoid colon and descending colon. Patient was then transferred to the recovery room in good condition. 

Looking at:
CPT 45378
ICD-9 V76.51, V10.05 and not sure about Lynch syndrome - any thoughts??

Thanks


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## barb.boek@gmaial.com (Apr 27, 2012)

Look @ V84.09 for the Lynch Syndrome


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## coachlang3 (Apr 27, 2012)

My only question is-is this truly a colon cancer screening?  Or did your doctor go in because of the Lynch Syndrome and the need to see if there should be a subtotal colectomy?

Just the way I read it makes me wonder about the colon cancer screening portion.


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## bridgettemartin (Apr 27, 2012)

In regards to the code for Lynch syndrome...look at v84.09.  You may also look at adding the primary CA site if there is one and it's known.


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