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The procedure described by CPT® Code 0886T involves a flexible sigmoidoscopy 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 narrowings of the bowel 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 not only mechanically dilate the stricture but also to deliver therapeutic agents directly to the affected area. This dual approach is intended to alleviate symptoms and minimize the likelihood of fibrotic tissue regrowth, thereby reducing the chances of stricture recurrence. The procedure is performed under fluoroscopic guidance, ensuring accurate placement and effective treatment of the stricture within the sigmoid colon.
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The procedure is indicated for the treatment of symptomatic benign bowel strictures, particularly when previous dilation attempts have been unsuccessful. The following conditions may warrant the use of this procedure:
The procedure begins with the insertion of a flexible endoscope into the rectum, which is then advanced through the anal canal and into the sigmoid colon. This allows the physician to visualize the bowel lumen and identify the specific area of the stricture. Once the stenosed area is located, a guidewire is introduced through the endoscope and advanced to the site of the stricture. Following this, a nondrug-coated balloon catheter is carefully advanced over the guidewire to the stricture site. The balloon is then inflated to mechanically dilate the narrowed segment of the bowel, allowing for improved passage. After a brief period, the balloon is deflated and removed. Subsequently, a drug-coated balloon catheter is passed through the operating channel of the endoscope, again over the guidewire. This balloon is inflated at the site of the stricture, delivering the therapeutic drug directly to the affected area while simultaneously dilating the stricture. The drug-coated balloon remains inflated for a specified duration to ensure effective drug delivery before being deflated and removed. Throughout the procedure, fluoroscopic guidance is utilized to enhance the accuracy of the interventions performed.
Post-procedure care typically involves monitoring the patient for any immediate complications or adverse reactions following the dilation and drug delivery. Patients may be advised to rest and may require follow-up appointments to assess the effectiveness of the treatment and monitor for any recurrence of symptoms. It is essential to provide patients with instructions regarding signs of complications, such as increased abdominal pain, bleeding, or changes in bowel habits, which should prompt immediate medical attention.
| Short Descr | SGMDSC FLX 1ST TNDSC DILAT | Medium Descr | SGMDSC FLX 1ST TNDSC DILAT RX BALO CATH STRIX | Long Descr | Sigmoidoscopy, 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 | 45330 Sigmoidoscopy, 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 |
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| 2025-01-01 | Added | First appearance in codebook. |
| 2025-01-01 | Changed | Medium Description changed. |
| 2024-07-01 | Added | Code added. |
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