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Adenoma(s) or other neoplasm not detected during screening colonoscopy (SCADR)

CPT4 code

Name of the Procedure:

Screening Colonoscopy for Adenoma(s) or Other Neoplasms Not Detected (SCADR)
Common Name: Colonoscopy
Technical Terms: Screening Colonoscopy, SCADR

Summary

A colonoscopy is a medical procedure where a doctor uses a long, flexible tube with a camera to look inside the colon and rectum. This is done to check for abnormal growths like adenomas or other neoplasms that were not detected during an initial screening.

Purpose

The primary aim of this procedure is to detect and remove any adenomas or other abnormal growths in the colon that were missed during a previous screening. This helps prevent colon cancer and other serious conditions.

Indications

  • Previous colonoscopy where adenomas or other neoplasms were not detected.
  • Patients with a family history of colon cancer.
  • Patients experiencing symptoms like rectal bleeding, unexplained weight loss, or persistent abdominal pain.

Preparation

  • Patients are usually required to fast for at least 12 hours before the procedure.
  • A bowel cleanse or laxatives may be prescribed to clear the colon.
  • Patients may need to adjust or temporarily stop medications, as advised by their doctor.
  • A pre-procedure health assessment will be performed to ensure the patient is fit for the procedure.

Procedure Description

  1. The patient will be asked to lie on their side on an examination table.
  2. Sedation or anesthesia will be administered to ensure comfort.
  3. The doctor will insert a colonoscope (a long, flexible tube with a camera) into the rectum and slowly advance it through the colon.
  4. The camera sends images to a monitor, allowing the doctor to examine the colon lining.
  5. If any adenomas or neoplasms are found, they can be removed or biopsied during the procedure.
  6. The colonoscope is then carefully withdrawn.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

  • Gastroenterologist or surgeon
  • Nurses
  • Anesthesiologist or sedation specialist

Risks and Complications

  • Common risks: Discomfort, bloating, and cramping.
  • Rare risks: Perforation of the colon, bleeding, or adverse reactions to sedation.
  • Possible complications: Infection or missed adenomas/neoplasms, which might require further treatment.

Benefits

  • Early detection and removal of adenomas, reducing the risk of colon cancer.
  • Immediate visual confirmation of colon health.
  • Most patients can resume normal activities within a day or two.

Recovery

  • Post-procedure, patients are monitored until the effects of sedation wear off.
  • Mild cramping or bloating is normal and usually resolves within a few hours.
  • Patients should avoid driving or operating machinery for 24 hours post-procedure.
  • A follow-up appointment may be required to discuss results and next steps.

Alternatives

  • Fecal occult blood test (FOBT)
  • Flexible sigmoidoscopy
  • Virtual colonoscopy (CT colonography)
  • Pros and cons: Non-invasive options are less comprehensive but have lower risk and shorter recovery times.

Patient Experience

  • During the procedure, with sedation, most patients feel minimal discomfort.
  • After the procedure, they may experience mild cramping or bloating, managed with rest and over-the-counter pain relief.
  • Clear instructions on diet and activity post-procedure will be provided to ensure a smooth recovery.

This markdown formatted description offers a concise yet comprehensive overview of the colonoscopy procedure for adenomas or other neoplasms not detected during screening, making it accessible and informative.

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