2025 CPT code 45393
(Active) Effective Date: N/A Revision Date: N/A Surgery - Endoscopy Procedures on the Rectum Surgery Feed
Colonoscopy with decompression for pathologic distention (e.g., volvulus, megacolon), including decompression tube placement.
Modifiers 52 (reduced services) and 53 (discontinued procedure) may be applicable depending on the circumstances of the procedure.
Colonoscopy with decompression is medically necessary when a patient presents with symptoms of pathologic colonic distention, such as severe abdominal pain and distention, caused by conditions like volvulus or megacolon.The procedure is aimed at relieving the distention and preventing potential complications.
The physician's responsibility includes prepping the patient, administering anesthesia (if necessary), inserting the colonoscope, identifying the cause of the distention, performing decompression (either by air insufflation or tube placement), and removing the scope (leaving a decompression tube in place if needed).
In simple words: The doctor uses a flexible tube with a camera (colonoscope) to look inside the large intestine and relieve pressure caused by a blockage or twisting.They may place a small tube to keep the pressure down.
This CPT code (45393) represents a flexible colonoscopy performed to decompress a pathologically distended colon.Distention may result from conditions such as volvulus (intestinal twisting) or megacolon (abnormally enlarged colon). The procedure involves inserting a flexible colonoscope to examine the colon's lumen, identifying the obstruction or abnormality causing the distention, and then performing decompression. This might involve introducing air to correct a volvulus or inserting a decompression tube at the site of the obstruction. The colonoscope is removed after the procedure; however, the decompression tube may be left in place if inserted.
Example 1: A 70-year-old patient presents with severe abdominal pain and distention. Colonoscopy reveals a volvulus (twisting) of the sigmoid colon. The physician performs a colonoscopy with decompression, relieving the volvulus. A decompression tube is left in place., A 55-year-old patient with a history of chronic constipation presents with severe abdominal pain and significant colonic distention (megacolon).Colonoscopy with decompression is performed, relieving the distention. No decompression tube is left in place., A 62-year-old patient post-colectomy presents with symptoms of intestinal obstruction and distention. Colonoscopy through a colostomy stoma is performed.The physician decompresses the distended colon and leaves a decompression tube in place for continued drainage.
* Detailed history and physical examination documenting the patient's symptoms (abdominal pain, distention).* Preoperative and postoperative diagnoses.* Indication for colonoscopy with decompression (e.g., volvulus, megacolon).* Documentation of the procedure performed (type of decompression, tube placement if applicable).* Operative report with details about the extent of the procedure and the findings.* Postoperative recovery notes.
** The type of decompression tube used should be specified in the operative report.If a different method of decompression is used other than a tube, this should also be clearly documented.
- Revenue Code: P8D
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Gastroenterology, Colon and Rectal Surgery, General Surgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center