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Wiki CT guided Gastrostomy Access Placement

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Jim Pawloski

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Patient has had a gastric bypass surgery, now needs a gastrostomy tube insertion. Under CT guidance, access was achieved with a 5 fr. Yueh catheter. The stomach was insufflated, and 4 gastropexy sutures were placed within the remnant stomach. Intraprocedural spot CT images demonstrated there to be gas and contrast within the gastric lumen, confirming positioning. Sterile dressings were applied and the patient was transferred to the Interventional Radiology department for Gastrostomy catheter placement. My question is can anything be coded for this CT portion or is it part of the gastrostomy insertion. The catheter was placed in IR.
 
I think it is included with G-tube insertion. If CT guided percutaneous G-tub replacement, without using fluoroscopic, code as 49999. If with fluoro, 49440.
 
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