suela923@aol.com
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I would like opinions on how to code this procedure please. The procedure was done in the IVU suite. I read it as IR was helping out endo but am being told we (IR) were the ones who were going to place the tube. Thanks, Sue
H&P Note:
We have been asked to perform image guided assistance for jejunal tube placement. Dr. M contacted Dr. F and requested that our service provide image guided needle placement with endoscopy guidance for jejunal access. This would facilitate wire passage into the jejunum to permit the endoscopist to place a jejunal feeding tube.
Procedure:
Fluoroscopy for attempted placement of jejunostomy tube
This examination was performed in conjunction with Dr. Horwath of gastroenterology. The study was performed with the anesthesiologist present. Time out procedure had been performed. Patient was prepped and draped in the usual sterile fashion. Dr. Horwath placed endoscope into the jejunum. We initially were able to transilluminate from the jejunum to the skin surface. Lidocaine was used for local anesthesia. A skinny needle was advanced, but unfortunately the scope migrated posteriorly and I was not able to gain access into the jejunum. We are unable to regain this position for subsequent attempt. A jejunostomy tube could not be placed.
Result Impression
Failed attempt at percutaneous jejunostomy tube placement.
H&P Note:
We have been asked to perform image guided assistance for jejunal tube placement. Dr. M contacted Dr. F and requested that our service provide image guided needle placement with endoscopy guidance for jejunal access. This would facilitate wire passage into the jejunum to permit the endoscopist to place a jejunal feeding tube.
Procedure:
Fluoroscopy for attempted placement of jejunostomy tube
This examination was performed in conjunction with Dr. Horwath of gastroenterology. The study was performed with the anesthesiologist present. Time out procedure had been performed. Patient was prepped and draped in the usual sterile fashion. Dr. Horwath placed endoscope into the jejunum. We initially were able to transilluminate from the jejunum to the skin surface. Lidocaine was used for local anesthesia. A skinny needle was advanced, but unfortunately the scope migrated posteriorly and I was not able to gain access into the jejunum. We are unable to regain this position for subsequent attempt. A jejunostomy tube could not be placed.
Result Impression
Failed attempt at percutaneous jejunostomy tube placement.