# villous adenoma of rectum



## MSUEEMBRY (Feb 14, 2013)

need help with CPT code 

OPERATIVE PROCEDURE  Transanal removal of a villous ademoma of the rectum

the tumor was removed with a flexible operative scope, a rigid sigmoidoscope, rectal retractors and excision.

Patient is prepped and draped in lithotomy position anal retractors put into place and the mass is visualized at appx. 12 cm. it was grasped with babcock clamps and pulled down  into the field, a portion of the tumor is removed by pulling it off, there is some bleeding, retractors are put back into position, bleeding is moderate, it is difficult to visualize the area,  this piece of tumor is removed,  the size is appx 3cm and raised.  the rigid sigmoidoscope is then put in and an attempt to grab the mass again and it breaks away, the operative flexible scope was then put into position and using a loop, the tumor is lassoed and grabbed with retractors and pulled down and again a portion of the tumor is pulled away,  it is decided at this point to remove the reminder of the tumor through a flexible scope with a large jumbo biopsy and a cautery snare loop,  the was done until the edge of the tumor is removed and then using cautery the edge of the tumor is burnt until there is no evidence of bleeding and there is a flat surgace where the tumor had been.  the patient tolerated the procedure well and was taken to recovery.


I am not sure where to start on this one.  I could use all your help!
Thanks in advance.


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## cynthiabrown (Feb 15, 2013)

have a look at 45171


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## MSUEEMBRY (Feb 18, 2013)

Thank you very much!


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## MSUEEMBRY (Feb 18, 2013)

Thank you very much!


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