mrolf
Guest
How would you code this colonoscopy? After adequate IV conscious sedation a digital rectal examination was performed and found to show a 3 cm pedunculated fibro-epithelial anal polyp. The scope was then inserted in the rectum and advanced under direct visualization throughtout the length of the colon. HE had significant amount of mucous in the distal portion of the colon making visualization somewhat difficult. Cecum was reached and photographed. Scope was the slowly withdrawn paying careful attention to all sidewalls. No abnormalities were noted. Scope was then retroflexed in the rectum. this appeared normal. Post-Procedure Diagnosis: Normal colonscopy and probable fibro-epithelial anal polyp. This was removed with 1% lidocaine and sicissors. Hemostasis achieved with silver nitrate. Do I code a 45378 and a 46230. Please advise. Thanks