Wiki Which gi tube insertion code?

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margaret fahy

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10/22/13

Guys,
For report below, dr. documents an AD catheter placement. He went in thru the existing G-tube, removed it, and then placed a catheter into the jejunum. So, which code would I use? 44500 is the AD cath placement, but he's starting out at G-tube site. 43761 does not seem to fit either.
Can I have some opinions, please?
Margie
ANTRO-DUODENAL CATHETER PLACEMENT

HISTORY: Feeding difficulties due to 536.3: Gastroparesis.

COMPARISON: No comparison available.


PROCEDURE: The indwelling G tube was injected and confirmed to be
in the gastric lumen. The retention balloon of the indwelling
gastrostomy tube was deflated and the old tube was removed. Via
the mature gastrostomy stoma a 5F JB-1 catheter with a .035"
Bentson wire was placed into the stomach and manipulated until
the wire was in small bowel distal to the ligament of Treitz. The
JB-1 catheter was removed and exchanged for AD catheter. Over the
wire the tube was advanced with fluoroscopic guidance until the
tip of the catheter was in jejunum and the proximal 3 radio
opaque markers were in the antral region. The wire was then
removed. Contrast injection confirmed position of the tip in the
catheter was in jejunum and the proximal 3 radio opaque markers
were in the antral region. There were no complications in the
patient left the IR suite in stable condition. Dr.
was present for the entire procedure.

IMPRESSION
Successful, uncomplicated placement of AD catheter.

Permanent fluoroscopic images were obtained and stored in the
PACS system
 
Hey guys...someone help me, please

Can someone please take a look at report below....just need some input as to which code you all would use.
Please.
Thanks so much.
Margie
 
margaret fahy said:
10/22/13

Guys,
For report below, dr. documents an AD catheter placement. He went in thru the existing G-tube, removed it, and then placed a catheter into the jejunum. So, which code would I use? 44500 is the AD cath placement, but he's starting out at G-tube site. 43761 does not seem to fit either.
Can I have some opinions, please?
Margie
ANTRO-DUODENAL CATHETER PLACEMENT

HISTORY: Feeding difficulties due to 536.3: Gastroparesis.

COMPARISON: No comparison available.



PROCEDURE: The indwelling G tube was injected and confirmed to be
in the gastric lumen. The retention balloon of the indwelling
gastrostomy tube was deflated and the old tube was removed. Via
the mature gastrostomy stoma a 5F JB-1 catheter with a .035"
Bentson wire was placed into the stomach and manipulated until
the wire was in small bowel distal to the ligament of Treitz. The
JB-1 catheter was removed and exchanged for AD catheter. Over the
wire the tube was advanced with fluoroscopic guidance until the
tip of the catheter was in jejunum and the proximal 3 radio
opaque markers were in the antral region. The wire was then
removed. Contrast injection confirmed position of the tip in the
catheter was in jejunum and the proximal 3 radio opaque markers
were in the antral region. There were no complications in the
patient left the IR suite in stable condition. Dr.
was present for the entire procedure.

IMPRESSION
Successful, uncomplicated placement of AD catheter.

Permanent fluoroscopic images were obtained and stored in the
PACS system
Click to expand...

I would code this as a conversion, not a replacement. Try 49446

HTH :)
 
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