Contrast Injection J-tube

imoore65

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Could you help me with a procedure code? Report dicated below.

Procedure: J-Tube Check

Contrast injected into a feeding tube showed the tube to be well positioned within the stomach. A large filling defect is present in the body of the stomach that persists with changes in patient positioning. It is not as well-defined on a delayed abdominal image. Contrast flows into the duodenum that is normal in caliber.

Conclusion: Gastrostomy tube in proper postion. Filling defects in the body of the stomach probably represent solidified ingested material. No evidence of stomach outlet obstruction.

I want to code this 49465 (contrast injection for radiological evaluation of exisiting gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy tube from a percutaneous approach including image documentation and report). Is this the correct code when the procedure is performed via a feeding tube? Our radiology tech assigned 49424, 76080, and 74000 (contrast injection for assessment of abscess or cyst via previously placed drainage catheter or tube) (radiological examinations, abdomen; single AP view).

Thanks for any feedback,

Ingrid Moore, CPC
 
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jtuominen

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You are correct--the code for this procedure is 49465.

The codes your tech selected are used for abscess drainage tube checks, for example for injection procedures involving drains placed in spontaneous abscesses that have developed due to a surgical complication. On those types of fluoroscopic tube checks I would typically bill 49424/76080, not sure where they came up with the 74000.

Per the definition, you use 49465 when you do a contrast injection of any of these tubes:
G, GJ, J, D, C or other colonic tubes.

Jayna RHIA, CIRCC, CCC
 
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