Interval of 3 or more years since patient's last colonoscopy, documented (End/Polyp)
CPT4 code
Name of the Procedure:
Colonoscopy (Endoscopy/Polypectomy)
Summary
A colonoscopy is a medical procedure where a long, flexible tube with a camera (colonoscope) is used to examine the interior of the large intestine (colon) and rectum. It helps detect changes or abnormalities such as inflamed tissue, ulcers, and polyps.
Purpose
The procedure is primarily used to screen for colorectal cancer, diagnose various digestive issues, and remove polyps or abnormal tissue. The main goals are early cancer detection, diagnosis of digestive problems, and prevention of colorectal cancer through polyp removal.
Indications
Patients who are recommended to have this procedure usually exhibit symptoms such as unexplained abdominal pain, rectal bleeding, chronic diarrhea, or changes in bowel habits. Additionally, individuals with a history of polyps, colon cancer, or certain genetic conditions are advised to undergo regular colonoscopies.
Preparation
Patients must follow a specific preparation regimen to clear the colon, typically involving a liquid diet and laxatives the day before the procedure. They may need to adjust or stop certain medications as advised by their doctor. Diagnostic tests such as blood work might be required to ensure the patient’s readiness.
Procedure Description
- The patient will lie on their side on an examination table.
- Sedation or anesthesia will be administered to ensure comfort during the procedure.
- The colonoscope is gently inserted through the rectum and guided through the colon.
- The camera sends images to a monitor, allowing the doctor to examine the colon lining.
- If polyps or abnormal tissue are detected, they may be removed or biopsied using specialized tools.
- The colonoscope is slowly withdrawn after the examination and any necessary procedures are completed.
Duration
Typically, a colonoscopy takes about 30 to 60 minutes.
Setting
The procedure is usually performed in a hospital or outpatient clinic with endoscopy facilities.
Personnel
The procedure is conducted by a gastroenterologist, with support from nurses and, if necessary, an anesthesiologist.
Risks and Complications
Common risks include bloating, cramping, and mild discomfort. Rare but serious complications include bleeding, perforation of the colon, or adverse reactions to sedation. Any complications can typically be managed with prompt medical intervention.
Benefits
The procedure allows for early detection and removal of precancerous polyps, significantly reducing the risk of developing colorectal cancer. Improved digestive health and accurate diagnosis of gastrointestinal symptoms are other benefits. Patients can usually expect results within a week.
Recovery
Post-procedure, patients will be monitored until the effects of sedation wear off. Mild cramping or bloating may occur but usually resolves within a few hours. Normal activity can often be resumed within a day, although driving and certain activities should be avoided for 24 hours post-sedation. Follow-up appointments are scheduled based on findings and individual patient needs.
Alternatives
Other screening methods include stool tests (e.g., fecal occult blood test), flexible sigmoidoscopy, and CT colonography. Each alternative varies in terms of invasiveness, preparation, and accuracy, with stool tests being less invasive but also less comprehensive.
Patient Experience
During the procedure, due to sedation, patients generally experience little to no discomfort and often have no memory of the event. After the procedure, most report feeling tired and may experience slight bloating or cramping. Effective pain management and supportive care are provided to ensure patient comfort and a smooth recovery.