2025 CPT code 45347
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Flexible sigmoidoscopy with placement of an endoscopic stent, including pre- and post-dilation and guide wire passage, when performed.
Modifiers 22 (increased procedural services), 50 (bilateral procedure), 52 (reduced services), 53 (discontinued procedure), and 59 (distinct procedural service) may be applicable depending on the circumstances of the procedure. Appropriate documentation is necessary to support modifier use.
The medical necessity for this procedure is established based on clinical findings and symptoms indicating bowel obstruction, stricture, or significant bleeding.Documentation should support the need for endoscopic intervention and stent placement.
The physician performs the sigmoidoscopy, assesses the need for stent placement, and places the stent using endoscopic techniques.They may also perform dilation before or after stent placement.This includes prepping the patient, inserting the sigmoidoscope, navigating to the site of the obstruction, and potentially using a guide wire and/or balloon catheter.
In simple words: The doctor uses a thin, flexible tube with a camera (sigmoidoscope) to examine the rectum and sigmoid colon. If a blockage is found, a small, expandable tube (stent) is inserted to open the passageway.The doctor may also widen the area before or after placing the stent.
This procedure involves a flexible sigmoidoscopic examination of the rectum and sigmoid colon.A stent is endoscopically introduced at a site of obstruction or stricture. Pre- and/or post-dilation may be performed, and a guide wire may be used to facilitate stent placement.The procedure includes the assessment of the obstruction or stricture, determining the appropriate stent length, and placement of the stent to alleviate the narrowing.
Example 1: A patient presents with symptoms of bowel obstruction. Sigmoidoscopy reveals a significant stricture in the sigmoid colon. A stent is placed to relieve the obstruction. Pre-dilation is performed using a balloon catheter before stent placement., A patient with a history of diverticulitis experiences recurrent bleeding.Flexible sigmoidoscopy reveals a small bleeding vessel in the rectum.The vessel is treated with endoscopic therapy which includes stent placement to reduce bleeding risk., A patient with Crohn's disease develops a severe stenosis in the sigmoid colon, leading to bowel obstruction. Sigmoidoscopy is performed. A stent is placed, and post-dilation is performed to ensure adequate patency. A guide wire is used to assist in stent placement.
Pre-procedure and post-procedure diagnoses, indication for the procedure (e.g., symptoms of obstruction, bleeding),description of the findings during the procedure (location and severity of the stricture or obstruction), type and size of stent used, details of any dilation performed (pre- or post-stent placement), and use of a guide wire.
** If fluoroscopic guidance is used during the procedure, code 74360 (fluoroscopic guidance) should be reported separately.
- Payment Status: Active
- Modifier TC rule: TC modifier not applicable.
- Specialties:Gastroenterology, Colorectal Surgery
- Place of Service:Office, Hospital, Ambulatory Surgical Center