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Cloacagram with scopes

Date: Feb 15, 2023

Question:

Hello Dr. Z,

How would you code a cloacagram where scopes were utilized? Would 52000 & 74775 be sufficient or is an unlisted more appropriate? The abdomen and perineum were prepped and draped in the usual sterile fashion. Endoscope was placed in the mucous fistula. A balloon catheter was then placed in the mucous fistula and the balloon inflated.

Cystoscope was performed and a balloon catheter with a marking catheter inserted within the lumen was placed into common channel. Contrast was injected into both catheters under fluoroscopy. BB was placed at perineum. Contrast included isovue and gadolinium. Catheters were capped. Rotational fluoroscopy was performed.

Urethra length was short and common channel length was approximately 3.25cm

Thanks Dr. Z!

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