G9612 Photodocumentation of two or more cecal landmarks to establish a complete examination

HCPCS code

#### Name of the Procedure:
**Photodocumentation of Two or More Cecal Landmarks to Establish a Complete Examination (HCPCS Code: G9612)**  
Common Names: **Cecal Photodocumentation, Colonoscopy Screening with Photodocumentation**

#### Summary
Photodocumentation of cecal landmarks involves taking pictures of specific parts of the cecum during a colonoscopy. This helps confirm that the examination of the colon is complete.

#### Purpose
This procedure is primarily used to ensure a thorough and complete colonoscopy examination. By documenting cecal landmarks, physicians can verify that they have inspected the entire colon, which is essential for detecting abnormalities, such as polyps or cancerous growths.

#### Indications
- Suspected or diagnosed colorectal cancer
- Persistent gastrointestinal symptoms (e.g., unexplained abdominal pain, bleeding)
- Routine screening for colorectal cancer, particularly in high-risk individuals
- Follow-up evaluation of previously identified polyps or abnormal findings

#### Preparation
- Patients are usually required to fast and undertake bowel preparation (e.g., laxatives or an enema) to clear the colon.
- Medication adjustments may include stopping blood thinners or other medications as advised by the doctor.
- Pre-procedure diagnostics may include blood tests and a review of medical history.

#### Procedure Description
1. The patient is given sedatives or anesthesia for comfort.
2. A colonoscope (a flexible, camera-equipped tube) is inserted through the rectum and guided through the colon.
3. High-resolution images are taken of at least two specific cecal landmarks.
4. The colonoscope is slowly withdrawn while the physician continues to inspect and photograph the colon lining.
5. Photodocumentation is saved for medical records to verify completion of the examination.

#### Duration
The entire procedure typically takes **30 to 60 minutes**.

#### Setting
The procedure is usually performed in an **outpatient clinic, hospital endoscopy suite, or surgical center**.

#### Personnel
- Gastroenterologist or other specialist performing the colonoscopy
- Nurses or medical assistants to aid in the procedure
- Anesthesiologist or nurse anesthetist if sedation is used

#### Risks and Complications
- **Common Risks**: Discomfort, bloating, or cramping immediately following the procedure
- **Rare Risks**: Perforation of the colon, significant bleeding, adverse reaction to sedatives, infections

#### Benefits
- **Expected Benefits**: Accurate and thorough examination of the colon, increased detection rates of polyps and other abnormalities, and a lower risk of missed lesions
- **Realization**: Immediate confirmation of examination completeness during the procedure

#### Recovery
- Patients typically rest in a recovery area until the sedative effects wear off.
- Mild discomfort or bloating may persist for a short period.
- Most individuals can resume normal activities within 24 hours.
- Follow-up appointments may be scheduled to discuss findings and any required treatments.

#### Alternatives
- **Other Options**: Virtual colonoscopy (CT colonography), sigmoidoscopy, fecal occult blood test (FOBT) or fecal immunochemical test (FIT)
- **Comparisons**: Virtual colonoscopy is less invasive but may not detect small polyps. Sigmoidoscopy covers only part of the colon.

#### Patient Experience
- **During the Procedure**: Patients are typically sedated and feel minimal discomfort.
- **After the Procedure**: Mild cramping or bloating is common; pain management with over-the-counter medications if necessary. Comfort measures include resting and hydrating post-procedure.

Medical Policies and Guidelines for Photodocumentation of two or more cecal landmarks to establish a complete examination

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