slwitt
Guest
Our General Surgeon was called in by a Gynecologist for consultation during a Vaginal Hysterectomy and BSO procedure because she dectected a small amount of blood during the rectal exam. The general surgeon was consulted and also performed a rectal exam and found small amount of blood tinged mucus on the finger but could not tell if this was from above or if this came from within the rectum. He decided to perform a Proctosigmoidoscopy while the patient was still under general anesthesia. The physician advanced 22 cm and found no evidence of any blood in the rectum or rectosigmoid colon or any hole, and the ridge that was previous felt during the exam was a sharp turn at approximately 5 to 6 cm. He felt that the blood was most likely from the vagina and he did not see any evidence of rectosigmoid injury.
Would you agree that 998.11 would be the appropriate code?
Does anyone have any suggestions on coding for this consult and procedure?
Thank you in advance for any advise.