CPT® Code 0885T

Official Description

Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed

Common Language Description

The procedure described by CPT® Code 0885T involves a flexible colonoscopy that incorporates an initial transendoscopic mechanical dilation, specifically utilizing a nondrug-coated balloon, followed by the therapeutic delivery of medication through a drug-coated balloon catheter aimed at treating colonic strictures. Colonic strictures are often symptomatic benign bowel obstructions that can arise from various underlying conditions, including surgical complications, radiation therapy, or inflammatory diseases affecting the intestine. The use of a drug-coated balloon, which may be coated with a medication such as paclitaxel, is designed to provide immediate therapeutic effects post-dilation. This procedure is performed under fluoroscopic guidance, ensuring precise placement and effective treatment of the stricture. The flexible colonoscope is introduced through the rectum and navigated through the colon to locate the stenosed area. Once identified, a balloon catheter is advanced over a guidewire to the stricture site, where it is inflated to mechanically dilate the narrowed segment. Following this initial dilation, the drug-coated balloon is introduced through the endoscope's operating channel, inflated, and held in place to deliver the medication directly to the stricture. This dual approach not only alleviates symptoms but also aims to minimize the risk of stricture recurrence by inhibiting the proliferation of fibrotic tissue.

1. Indications

The procedure described by CPT® Code 0885T is indicated for the treatment of symptomatic benign bowel strictures. These strictures may result from various conditions, including:

Surgical Complications Strictures can develop as a result of previous surgical interventions in the gastrointestinal tract.
Radiation Therapy Patients who have undergone radiation treatment for pelvic cancers may experience strictures due to tissue damage.
Inflammatory Diseases Conditions such as Crohn's disease or ulcerative colitis can lead to the formation of strictures in the bowel.

2. Procedure

The procedure begins with the insertion of a flexible colonoscope into the rectum, which is then advanced through the colon to locate the area of the stricture. Once the stenosed segment is identified, a guidewire is introduced through the colonoscope to facilitate the placement of a balloon catheter. The first step involves advancing a nondrug-coated balloon catheter over the guidewire to the site of the stricture. This balloon is then inflated to mechanically dilate the narrowed area, providing initial relief of the obstruction. After the balloon is inflated and left in place for a brief period, it is deflated and removed. Following this initial dilation, the next step involves the introduction of a drug-coated balloon catheter through the operating channel of the endoscope, again utilizing the guidewire for accurate placement. The drug-coated balloon is inflated at the site of the stricture, allowing for the delivery of the therapeutic agent directly to the affected tissue. This inflation not only dilates the stricture further but also applies the drug, which is intended to provide symptomatic relief and reduce the likelihood of fibrotic tissue growth, thereby helping to prevent recurrence of the stricture.

3. Post-Procedure

Post-procedure care following the colonoscopy with drug-coated balloon dilation typically includes monitoring the patient for any immediate complications, such as bleeding or perforation. Patients may be advised to rest and gradually resume normal activities. Follow-up appointments may be necessary to assess the effectiveness of the procedure and monitor for any signs of stricture recurrence. It is essential for healthcare providers to provide patients with specific instructions regarding diet, activity level, and any signs or symptoms that should prompt immediate medical attention.

Short Descr	COLSC FLX 1ST TNDSC DILAT
Medium Descr	COLSC FLX 1ST TNDSC DILAT RX BALO CATH CLN STRIX
Long Descr	Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, including fluoroscopic guidance, when performed
Status Code	Carriers Price the Code
Global Days	000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	3 - Special payment adjustment rules for multiple endoscopic procedures apply.
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Endoscopic Base Code	45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator	Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Berenson-Eggers TOS (BETOS)	none
MUE	1