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Resolved Reporting proctoscopy CPT for passage of the stapler and not anastomotic integrity?

LoganR_46098

New member
Can we report CPT 45300 with 44204 and 44207 if the procto is being done to evaluate the rectum for passage of the stapler not to check anastomotic integrity?
 
45300 - Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
44204 - Laparoscopy, surgical; colectomy, partial, with anastomosis
44207 - Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)

I do not believe you can do that. Here is what I have on the procedure itself. Not seeing the note of course I am guessing.
The segment of colon to be resected is mobilized to allow for exteriorization of the bowel. The incision at one of the lower abdominal trocar sites is enlarged. In 44207, the divided end of the rectosigmoid colon is brought through the incision in the abdominal wall and the bowel exteriorized to a point beyond the proximal resection site. The proximal resection site is identified and resected using clips and harmonic scalpel. After placing a purse-string suture and anvil around the end of the remaining portion of bowel, the exteriorized bowel is returned to the abdomen and the exteriorization incision closed. A stapler is passed through the anus and the spike advanced out through the rectal stump. The stapler and anvil are mated and the stapler fired to create an end-to-end anastomosis of the rectal stump and colon. In 44208, the resection and anastomosis are performed as described above. A diverting colostomy is then created. An incision is made in the lower abdomen, usually on the right side. The stoma site is prepared and a loop of colon brought through the abdominal wall, folded back on itself (everted), and sutured to the skin and subcutaneous tissue. Trocars are removed and portal incisions closed. A colostomy appliance is placed at the stoma site.
 
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