EGD w/removal PEG and conversion to GJ

judyp53

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Apple Valley, MN
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Looking for help with this scenario: video endoscope introduced per os and directed under direct visualization. Esophagus appeared normal in it's entirety as did stomach and proximal duodenum. The existing PEG was visualized with the J going transpylorically. The J was pulled, the PEG was cut at the skin level and taken out the mouth using basket snare. Endoscope replaced showing gastric depth of 2.5 cm, therefore a 16x2.5x30 cm length skin level GJ button was sewn into the stoma and directed with both endoscopic care initially into the pylorus and then rat-tooth was used to push down into the duodenum. From there, fluoroscopic dye was used to show good C-loop position. Water-soluble dye was used. Balloon insufflated with 6 cc water.

I am escpecially interested in the coding of the fluoroscopy - thoughts?

Thanks!
Judy
 

Anna Weaver

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Kokomo, IN
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peg to gj

Looking for help with this scenario: video endoscope introduced per os and directed under direct visualization. Esophagus appeared normal in it's entirety as did stomach and proximal duodenum. The existing PEG was visualized with the J going transpylorically. The J was pulled, the PEG was cut at the skin level and taken out the mouth using basket snare. Endoscope replaced showing gastric depth of 2.5 cm, therefore a 16x2.5x30 cm length skin level GJ button was sewn into the stoma and directed with both endoscopic care initially into the pylorus and then rat-tooth was used to push down into the duodenum. From there, fluoroscopic dye was used to show good C-loop position. Water-soluble dye was used. Balloon insufflated with 6 cc water.

I am escpecially interested in the coding of the fluoroscopy - thoughts?

Thanks!
Judy
Look at 49446 conversion of gastrostomy to gastro-jejunostomy, percutaneous under fluoroscopic guidance including contrast. See if this might help, and fluoro is inclusive.
 
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