Enterocutaneous Fistula Plug
Is anyone currently using the enterocutaneous fistula plug at their facility? How are you coding this, 44799? If so, do you mind sharing approximate reimbursement you are receiving for these procedures?
This may not be the same thing as your procedure bu this was just posted on the RBMA (Radiology Business Managers Association) Coding Forum. Walt Blackham is on the AMA board and several other boards.
Subject: Re: Enterocutaneous Fistula Closure
UPC for the closure and 20501+ 76080 for contrast injecton prior to closure. That's about the best I can come up with.
On 9/24/2010 5:48 PM, Coder wrote:
How would the following note be coded? Probably an unlisted code either 44799 or 17999 and 76496? Thank you for your help.
HISTORY: Enterocutaneous fistula from a prior jejunostomy tube which has had persistent high volume output for 3 months.
PERCUTANEOUS ENTEROCUTANEOUS FISTULA CLOSURE USING FLUOROSCOPIC GUIDANCE
PROCEDURE: A PARQ conference was held and written consent to proceed was obtained. The skin overlying the left lower abdomen was prepped in a sterile fashion. Subcutaneous lidocaine was injected for local anesthesia. A 5-French Kumpe catheter was advanced into a enterocutaneous fistula and contrast dye was injected to opacify the fistula tract. A wire was then passed into the jejunum through the tract. The tract was then sequentially dilated. A 22-French sheath was advanced over the wire and positioned in the jejunum. A 7-mm Cook enterocutaneous fistula plug was then deployed within the enterocutaneous fistula tract under fluoroscopy. 1 g Ancef was flushed into the sheath. The sheath was removed. The device was then sutured to the skin using resorbable Vicryl suture. The device was trimmed and a Molnar disk was attached.
CONCLUSION: Successful placement of a percutaneous enterocutaneous fistula plug under fluoroscopic guidance. The patient was placed on a clear diet for two days. She will follow-up in radiology in two weeks.
Concerning the questions about sclerotherapy.. If 4 separate distinct injections were made to the superficial veins in the left axilla can we use cpt 36470 x4 or should we use 36299. Injections weren't done on spider veins? Any help is appreciated.
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