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Thread: Revision of jejunostomy tube

  1. #1

    Default Revision of jejunostomy tube

    AAPC: Back to School

    I need help on finding a cpt code for revision of a jejunostomy tube, if anyone could help me that will be greatly appreciate it.

    The patient was brought to the operating room, placed in supine position, and
    prepped and draped in the usual sterile manner. An upper incision was made
    through which the subcutaneous tissue was divided using electrocautery. The
    abdomen was entered sharply. The Witzel jejunostomy tube was easily
    identifiable. The sutures holding it to the anterior abdominal wall were
    removed. The suture holding the tube to the skin was removed. The small bowel
    with the tube was brought out through a midline incision. The Witzel tunnel
    was inspected. This may have caused compromise of the lumen of the small
    bowel. The Witzel tunnel was removed. The sutures were removed. A pursestring
    suture was replaced around the tube. This maneuver, removing the sutures,
    seemed to relieve the obstruction. It appeared that the lumen was widely

    The area was irrigated. The bowel was returned to the abdomen and the small
    bowel was sutured to the anterior abdominal wall circumferentially around the

    An upper GI endoscopy was then performed. Through the oropharynx after the
    patient was chemically relaxed, the Olympus scope was passed. It was passed
    into the esophagus under direct endoscopic vision. We were able to identify
    in the distal esophagus the cancer and entered the stomach. We then
    insufflated and insufflated the duodenum. At the bedside, the air could be
    seen passing the area of the J-tube without any evidence of restriction of
    flow. There appeared to be no narrowing of the lumen of the small bowel.
    Succus was also able to be refluxed through this area seemingly without

    The stomach was decompressed. The scope was removed and the esophagus was
    inspected in a retrograde fashion. There was no evidence of injury to the
    injury to the esophagus.

    The abdomen was copiously irrigated. Two cc were placed into the jejunal tube
    balloon. The balloon was anchored to the skin with a 4-0 Vicryl stitch. The
    wound was irrigated again and injected with 0.25% Marcaine. The fascia was
    closed with 0 looped Maxon followed by a 3-0 Vicryl, and then a 4-0 Vicryl
    subcuticular stitch. Steri-Strips were placed. The wounds were dressed. The
    patient was brought to recovery in good condition. There were no
    complications and the patient tolerated the procedure well.

  2. #2
    Join Date
    Apr 2007
    Jacksonville Florida Chapter


    I found 44373 for revision of a jejunostomy tube.
    John Meyer, CPC-A
    Heekin Orthopedic Specialists

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