Need Opinions Please!!

Milford, OH
Best answers
Hi everyone!

I wanted to see what everyone would think for this case that I have for a placement of a feeding tube. I need opinions on the CPT code used.

Patient is seen for and EGD(esophagogastroduodenoscopy). He is status post gastric bypass and no longer has a stomach it is just a gastric pouch. The provider "Using the endoscope, a feeding tube was passed under endoscopic guidance into the esophagus and advanced into the gastric pouch. Subsequently the tip of the tube was grasped using a rat-tooth forceps and guided into the jejunal loop. The scope was removed. The tube was bridled at the nose."

What CPT code would you use?

43235- upper gastrointestinal endoscopy including esophagus, stomach and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing

43246 - Esophagogastroduodenoscopy, Flexible, transoral, with directed placement of percutaneous gastrostomy tube.

49441- Insertion of duodenostomy or jejunostomy tube, under fluoroscopic guidance including contrast injection(s)

or use an unlisted procedure code?