# colonoscopy before colostomy takedown



## lindacoder (Oct 26, 2009)

I don't do these often enough to feel comfortable.

Medicare patient - report reads the colonoscope was inserted into the colostomy bag. This was advanced to the cecum without difficulty. The ileocecal valve was identified as was the ascending colon. The hepatic flexure was also identified. We were able to visualize this completely. There was no evidene of polyps in any of this part of the bowel. Attempts to cannulate the ileocecal valve were not successful. The cecum was normal as was the ascending colon. The hepatic flexure was normal. The transverse colon was normal as was the splening flexure and descending colon. The patient tolerated this part of the procedure well. The scope was then inserted into the rectum and the rectum was scoped to a distance of about 25 cm. This appeared to be normal colon with a few diverticular outpouchings of the distal segment. There was some diversion proctitis and a little bit of inflamed mucosa. The scope was retroflexed and no hemorrhoids were noted. 

I need a CPT code and can I use the V55.3 (attention to colostomy) ICD-9 code.  Thanks for any help.


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## genacodes (Nov 25, 2009)

Hi Linda, 

Take a look at 44388 and 45330. That is where I would start. 

Hope this was helpful.


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