ALTERNATIVA DE ABASTECIMIENTO 7

44900 Incision and drainage of appendiceal abscess; open

EXCISION

44950 Appendectomy;

(Incidental appendectomy during intra-abdominal surgery does not warrant a separate identification)

44955 when done for indicated purpose at time of other major procedure (not as separate procedure)

(List separately in addition to primary procedure)

44960 for ruptured appendix with abscess or generalized peritonitis

LAPAROSCOPY

Surgical laparoscopy always includes diagnostic laparoscopy. 44970 Laparoscopy, surgical, appendectomy

44979 Unlisted laparoscopy procedure, appendix

RECTUM INCISION

45000 Transrectal drainage of pelvic abscess

45005 Incision and drainage of submucosal abscess, rectum

45020 Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess (See also 46050, 46060)

EXCISION

45100 Biopsy of anorectal wall, anal approach (eg, congenital megacolon) 45108 Anorectal myomectomy

45110 Proctectomy; complete, combined abdominoperineal, with colostomy 45111 partial resection of rectum, transabdominal approach

45112 Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo- anal anastomosis)

45113 Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S or J), with or without loop ileostomy

45114 Proctectomy, partial, with anastomosis; abdominal and transsacral approach 45116 transsacral approach only (Kraske type)

45119 Proctectomy, combined abdominoperineal pull-through procedure (eg, colo- anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy when performed

45120 Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type operation)

45121 with subtotal or total colectomy, with multiple biopsies 45123 Proctectomy, partial, without anastomosis, perineal approach

45126 Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof

45130 Excision of rectal procidentia, with anastomosis; perineal approach 45135 abdominal and perineal approach

45136 Excision of ileoanal reservoir with Ileostomy

(Do not report 45136 in addition to 44005, 44120, 44310) 45150 Division of stricture of rectum

45160 Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach 45171 Excision of rectal tumor, transanal approach; not including muscularis propria

(ie, partial thickness)

45172 including muscularis propria (ie, full thickness)

(For destruction of rectal tumor, transanal approach, use 45190)

DESTRUCTION

45190 Destruction of rectal tumor, (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach

ENDOSCOPY

DEFINITIONS:

PROCTOSIGMOIDOSCOPY- is the examination of the rectum and sigmoid colon.

SIGMOIDOSCOPY- is the examination of the entire rectum, sigmoid colon and may

include examination of a portion of the descending colon.

COLONOSCOPY- is the examination of the entire colon, from the rectum to the cecum,

and may include the examination of the terminal ileum.

(Surgical endoscopy always includes diagnostic endoscopy)

45300 Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)

45303 with dilation, (eg, balloon, guide wire, bougie) 45305 with biopsy, single or multiple

45307 with removal of foreign body

45308 with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery

45309 with removal of single tumor, polyp, or other lesion by snare technique 45315 with removal of multiple tumors, polyps, or other lesions by hot biopsy

forceps, bipolar cautery or snare technique

45317 with control of bleeding, (eg, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)

45320 with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (eg, laser)

45321 with decompression of volvulus

45327 with transendoscopic stent placement (includes predilation)

45330 Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

45331 with biopsy, single or multiple 45332 with removal of foreign body(s)

45333 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps 45334 with control of bleeding, any method

45335 with directed submucosal injection(s), any substance

45337 with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube when performed

45338 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

45346 with ablation of tumor(s), polyp(s), or other lesions(s), (includes pre- and post-dilation and guide wire passage, when performed) 45340 with transendoscopic balloon dilation

45341 with endoscopic ultrasound examination

45342 with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)

45347 with placement of endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed)

45349 with endoscopic mucosal resection

45350 with band ligation(s) (eg, hemorrhoids)

45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

45379 with removal of foreign body(s) 45380 with biopsy, single or multiple

45381 with directed submucosal injection(s), any substance 45382 with control of bleeding, any method

pre- and post-dilation and guide wire passage, when performed)

45384 with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps 45385 with removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45386 with transendoscopic balloon dilation

45389 with endoscopic stent placement (including pre- and post-dilaton and guide wire passage, when performed)

45391 with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse or ascending colon and cecum, and adjacent structures

45392 with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures

45390 with endoscopic mucosal resection

45393 with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed

45398 with band ligation(s) (eg, hemorrhoids)

LAPAROSCOPY

Surgical laparoscopy always includes diagnostic laparoscopy. EXCISION

45395 Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy

45397 proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy, when performed

REPAIR

45400 Laparoscopy, surgical; proctopexy (for prolapse) 45402 proctopexy (for prolapse), with sigmoid resection 45499 Unlisted laparoscopy procedure, rectum

REPAIR

45500 Proctoplasty; for stenosis

45505 for prolapse of mucous membrane

45520 Perirectal injection of sclerosing solution for prolapse 45540 Proctopexy (eg, for prolapse); abdominal approach 45541 perineal approach

45560 Repair of rectocele (separate procedure)

45562 Exploration, repair, and presacral drainage for rectal injury; 45563 with colostomy

45800 Closure of rectovesical fistula; 45805 with colostomy

45820 Closure of rectourethral fistula; 45825 with colostomy

MANIPULATION

45900 Reduction of procidentia (separate procedure) under anesthesia

45905 Dilation of anal sphincter (separate procedure) under anesthesia other than local

45910 Dilation of rectal stricture (separate procedure) under anesthesia other than local

45915 Removal of fecal impaction or foreign body (separate procedure) under anesthesia

OTHER PROCEDURES

45399 Unlisted procedure, colon (Report required)

45999 Unlisted procedure, rectum

ANUS