drobinson1
Networker
Good afternoon coders,
I hate unsuccessful procedures. I'm never sure what I can bill. Here's the report and the question I have is below it:
Clinical History:
Recently placed gastric jejunostomy tube is now clogged.
Patient was brought to the radiology suite to attempt unclog the J portion of his gastrojejunostomy tube. Patient was placed on the angiography table in supine position. Digital scout image was obtained. Attempt to pass a guidewire through the J portion of the tube under fluoroscopy was unsuccessful. Attempts were made to clear the tube by vigorous flushing with carbonated beverage.
None of these attempts was successful.
Prior to prepping the tube for removal and replacement, the patient became agitated and was having difficulty maintaining O2 saturation on his ventilator. The procedure was terminated and the patient transported to the emergency department for better assessment of his respiratory status.
The patient will be brought back when stable 4 exchange of the indwelling gastric jejunostomy tube.
IMPRESSION:
Unable to unclogged jejunostomy portion of the patient's gastrojejunostomy tube. Please see above.
I read in Dr. Z's Interventional Radiology Coding Reference the if the tube clearance is not successful and the tube must be replaced, do not code the tube clearance code 49460. Only code for the appropriate tube replacement code. But what if the clearance is not successful can we bill 49460 or should we just bill for the images taken?
I hate unsuccessful procedures. I'm never sure what I can bill. Here's the report and the question I have is below it:
Clinical History:
Recently placed gastric jejunostomy tube is now clogged.
Patient was brought to the radiology suite to attempt unclog the J portion of his gastrojejunostomy tube. Patient was placed on the angiography table in supine position. Digital scout image was obtained. Attempt to pass a guidewire through the J portion of the tube under fluoroscopy was unsuccessful. Attempts were made to clear the tube by vigorous flushing with carbonated beverage.
None of these attempts was successful.
Prior to prepping the tube for removal and replacement, the patient became agitated and was having difficulty maintaining O2 saturation on his ventilator. The procedure was terminated and the patient transported to the emergency department for better assessment of his respiratory status.
The patient will be brought back when stable 4 exchange of the indwelling gastric jejunostomy tube.
IMPRESSION:
Unable to unclogged jejunostomy portion of the patient's gastrojejunostomy tube. Please see above.
I read in Dr. Z's Interventional Radiology Coding Reference the if the tube clearance is not successful and the tube must be replaced, do not code the tube clearance code 49460. Only code for the appropriate tube replacement code. But what if the clearance is not successful can we bill 49460 or should we just bill for the images taken?