What is Chromoendoscopy?
Chromoendoscopy, sometimes called chromo colonoscopy and chromoscopy, is an endoscopic treatment in which topical stains or dyes are used. It is intended to enhance the sensitivity of colonoscopy by facilitating the detection of mucosal abnormalities, especially flat or depressed lesions. There are two kinds of chromoendoscopy. In one, dyes or stains are sprayed through the endoscope’s working tube. The other method, virtual chromoendoscopy, uses a computer algorithm to imitate the various colors of light produced by dye or stain spraying.
Untargeted chromoendoscopy can be performed throughout the entire colon (pan colonic chromoendoscopy), while targeted chromoendoscopy is performed on a specific lesion or lesions. Colorectal, esophageal, gastric, and small bowel dysplasia surveillance and high-risk populations including those having inflammatory bowel disease are further benefits.
Chromoendoscopy employs stains, pigments, or dyes to find malignant lesions in the digestive tract mucosa.
Regular GI endoscopy involves inserting an endoscope (a flexible, thin tube with a camera) through the anus or mouth to look at a specific area of the gastrointestinal tract. The doctor can identify certain malignant alterations with endoscopy, but not all. Administering a reagent (a substance that leads to a chemical reaction, like a stain or color) to the mucosa can help find suspicious spots where the doctor wants to do a biopsy to rule out cancer.
Chromoendoscopy is often performed in conjunction with an upper GI endoscopy or a colonoscopy; therefore, the preparation is contingent upon these procedures.
Patients preparing for Chromoendoscopy must do as their doctors direct, which includes consuming only clear liquids, fasting, bowel preparation, or a mix of these. It’s crucial to prepare for transportation to and from the procedure because the upper endoscopy and colonoscopy both contain sedative medicine.
A gastroenterologist uses an endoscope with a specialized catheter attachment during an upper GI endoscopy or colonoscopy to apply a dye or stain onto the interior of the gastrointestinal tract and look for any places that respond differently to the substance. A tissue sample (biopsy) is taken by the doctor and examined closely in the lab.
In chromoendoscopy, the lining of the stomach, intestines, or esophagus is sprayed with a thin mist of dye using a flexible tube known as an endoscope. Chromoendoscopy can be less complicated, riskier, and more affordable than other imaging methods.
There are two main types of stain used in dye-based chromoendoscopy:
- Absorptive stains (like methylene blue).
- Contrast stains (like indigo carmine).
The dyes frequently used in this procedure are as follows:
- The epithelial cells lining the small and large intestines absorb methylene blue and turn a vivid blue color when exposed to the dye, while dysplastic and malignant lesions remain unstained. A topical methylene blue solution evaluates dysplastic abnormalities in the large intestine, small intestine, esophagus, and stomach. Methylene blue can also detect colonic and intraepithelial neoplasia in ulcerative colitis patients.
- Dark blue indigo carmine is used to highlight the topography of the mucosa by coating its depressions, pits, erosions, and structures.
The following are some of the purposes of this procedure:
- This method of endoscopy, often known as chromoendoscopy, makes use of stains to highlight malignant and dysplastic alterations that are not visible in white light as well as variations in the mucosa during endoscopy. During endoscopy, chromoendoscopy is utilized to enhance the detection rates of various pathologic processes.
- Chromoendoscopy is frequently used for evaluating polyps in the colon, checking for Barrett’s esophagus, and monitoring dysplasia in inflammatory bowel disease (IBD).
- The GI tract can also be examined via chromoendoscopy at any point along its length. If somebody experiences precancerous symptoms or is at a high risk of developing cancer due to hereditary or environmental causes, then the doctor advises this operation.
Chromoendoscopy CPT Code
Chromoendoscopy does not have any specified code. Undocumented CPT number 44799 is likely used to account for the additional work involved in chromoendoscopy.