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Thread: Replacement of dislodged jejunostomy tube

  1. #1
    Join Date
    Apr 2007
    Manchester, NH

    Default Replacement of dislodged jejunostomy tube

    AAPC: Back to School
    Looking for opinions for coding this procedure:
    The former feeding jejunostomy tube site was triply prepped and appropriately draped. With lubrication, a 12 French red Robinson catheter was gently reinserted into the former J-tube tract without difficulty. It was affixed to the skin temporarily. Placement of the tube was verified via portable abdominal x-ray with injection of 60 mL half-strength Gastrografin. When it was confirmed that the feeding tube was in the jejunum, the tube itself was affixed to the skin. The skin surrounding the J-tube was again triply prepped and appropriately draped in a sterile fashion. The surrounding skin was infiltrated with 1% Lidocaine. It was determined that adequate anesthesia was obtained. A single suture of 2-0 nylon was placed in the skin and the drain was affixed without difficulty. A jejunostomy tube easily flushed and was productive of bilious drainage. A dry sterile dressing was applied.

    Thoughts include:
    Code 49451 is almost appropriate; however it speaks of using fluoroscopy – which was not utilized in this case. Placement was confirmed with a portable abdominal film with contrast.

    Do you think 49999 would be most appropriate in this case?

  2. #2

    Default Replacement of dislodged jejunostomy tube

    We will not use 49999 for this procedure.
    we can use 49451 which is more appropriate.

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