Wiki Digestive Coding Assistance Please

[ccillo]

Need assistance with the following 2 scenarios please:

1. percutaneous placement of gastrostomy tube w/ radiological S & I

2. endoscopic placement of gastrostomy tube w/radiological S & I

With rationale please.

I think I am being thrown off because the only radiological S & I I can find is for Removal not placement and in the CPT book right before CPT code 74210 there is a note that states for percutaneous placement of gastrostomy tube, use 43246 however this code does not include radiological S & I and then under 43246 there is another note that states for nonendoscopic percutaneous placement of gastrostomy tube, see 49440. But doesn't percutaneous mean throught the skin by needle..which would be nonendoscopic?

Hope I am making sense, I am a little rusty in this specialty.

Thanks,

~Cindy Cillo, CPC

 

[judyarnold]

49440 includes includes fluoro guidance, contrast injections,image documentation and report. So, there no longer is a seperate S&I to code with 49440. It is an all inclusive code. This is the code used when the procedure is performed in Interventional Radiology.

If this was done by the GI docs endoscopically, I would use 43246. My question is: was there a need to use fluoro to place this tube?

Sorry I'm answering your question with a question:

Judy