# Help, removal of fecal impaction in colostomy



## cvickid (Aug 21, 2008)

I need to know if there is any kind of code for removal of a fecal impaction in a colostomy _without_ anesthesia.  This was done in the office.
Thanks


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## pharmon (Aug 21, 2008)

i've used the fecal impaction 560.39 and the v55.3 before for this same thing.


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## Treetoad (Aug 21, 2008)

There doesn't appear to be a code for this unless it's under anesthesia.  It would be included in the E&M service.  45915 is used with anesthesia, and there is no distinction of colostomy/anus.


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## mbort (Aug 21, 2008)

from CPT assistant:

Question: Is it appropriate to report CPT code 45915, Removal of fecal impaction or foreign body (separate procedure) under anesthesia, when conscious sedation is used?

AMA Comment:No. CPT code 45915 is intended to be reported for fecal impaction or foreign body removals only when performed under general anesthesia. The CPT code descriptors that include the phrase "requiring anesthesia" or "under anesthesia" indicate that the work involved in that specific procedure requires the use of general anesthesia; therefore, it would not be appropriate to report code 45915 if general anesthesia is not provided. *Fecal impaction or foreign body removal performed with other anesthetics is considered inclusive to the appropriate evaluation and management service code.*

However if this was done with Pulsed irrigation, you may want to look at 91123


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