Radiology Coding Alert

Question: Our radiologist inserted an enteroclysis tube. How should we report this service and the imaging that he used when placing the tube?

New Jersey Subscriber

Answer: The answer depends on the method that the radiologist uses.

If he places the tube percutaneously during another procedure, report +44015 (Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method [list separately in addition to primary procedure]) with 74355 (Percutaneous placement of enteroclysis tube, radiological supervision and interpretation).

If the radiologist performs the procedure through a gastrostomy tube, you should report 43761 (Repositioning of the gastric feeding tube, any method, through the duodenum for enteric nutrition) with 75984 (Change of percutaneous tube or drainage catheter with contrast monitoring [e.g., gastrointestinal system, genitourinary system, abscess], radiological supervision and interpretation) for the supervision.

For transoral or snare placements, you should report 44500 (Introduction of long gastrointestinal tube [e.g., Miller-Abbott] [separate procedure]) with the supervision code 74340 (Introduction of long gastrointestinal tube [e.g., Miller-Abbott], including multiple fluoroscopies and films, radiological supervision and interpretation).

If you can't determine which code best applies to the procedure that your physician documented, you should ask the radiologist to select the appropriate codes.

If the physician performs and documents x-rays of the small intestine during the tube placement, you can also report 74251 (Radiologic examination, small intestine, includes multiple serial films; via enteroclysis tube).