Urology -Cystourethroscopy w fulguration via stoma

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Highland, NY
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urologist accessed the bladder thru an existing stoma instead of the urethra


A 16-French flexible cystoscope was inserted per the IP stoma and entered into the bladder with no difficulty. A pan pouchoscopy was performed. There were multiple rugae noted. The bladder was filled and thoroughly inspected. There was an area on the posterior wall that appeared to be mildly ulcerated versus catheter associated traumatization, and so we took a biopsy of the specimen. We then fulgurated the area thoroughly and excellent hemostasis was achieved. The bladder was then emptied out and then filled again and no additional masses, stones, or defects were noted, other than our 1 site of biopsy. There were additional areas of edema which were more consistent with catheter associated irritation. At the end of the case, the bladder was left full and a 14-French catheter was inserted without difficulty into the bladder with return of clear yellow urine

Can the 55204 still be used regardless of approach or should 44382 be used
 
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