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43241 or 43752 or 44360

Eleen Posted Tue 04th of December, 2012 17:50:26 PM

Small bowel enteroscopy

Indications: For therapy of duodenal stenosis, severe pancreatitis, The Colonoscope was introduced through the mouth and advanced to the proximal jejunum. monitored continuously. The small
bowel enteroscopy was accomplished without difficulty. The patient tolerated the procedure well. Procedure:The esophagus was normal.
The stomach was normal.A benign-appearing, intrinsic stenosis that was traversed was found in the first part of the duodenum. A previously placed internal/external biliary drain was seen in the duodenum. There was no evidence of significant pathology in the proximal jejunum. A 8 Fr nasojejunal tube was advanced through
the scope into the jejunum. Placement was confirmed by fluoroscopy.
- Duodenal stenosis.
- Otherwise normal push enterosccopy.
- 8Fr Nasojejunal feeding tube placed.

Really confused?

SuperCoder Answered Wed 05th of December, 2012 23:02:01 PM


We are working on this and will get back soon.


Eleen Posted Thu 06th of December, 2012 21:03:27 PM

Thanks you

SuperCoder Answered Thu 06th of December, 2012 21:06:42 PM


I would recommend using 44372 for this case.

In this procedure, the physician passes an instrument called an endoscope through the mouth into the stomach (endoscopy) or first portion of small bowel (duodenum) or beyond second portion of duodenum (enteroscopy) but not including ileum, to evaluate the interior structure or any abnormalities and performs a percutaneous jejunostomy tube placement. This procedure may be performed under moderate sedation along with local anesthesia. First the patient is taken to the operating room and placed on the surgical table lying on his back. Local anesthetic spray is administered in the mouth and throat to make the area insensitive. Gastroenterologist then places a plastic mouthpiece (also called bite block) to keep the mouth open and inserts a thin, flexible, fiberoptic endoscope fitted with surgical instruments through the mouthpiece and advances the scope towards the stomach once patient's swallows it. The physician then guides the scope containing enteroscope under direct visualization through the stomach into the first portion of small bowel (duodenum). A small camera affixed on the endoscope sends out images to a TV monitor, which helps the physician to visualize magnified picture of the intestinal lining and analyze the interior structure without any difficulty. The gastroenterologist inspects mucosal linings of esophagus, stomach, upper portion of duodenum, and also second portion of duodenum, may include whole portion of the jejunum, but not ileum. Once inspection is completed, the physician starts the process for placement of jejunostomy tube via percutaneous approach. He inserts jejunostomy tube endoscopically through mouth and moves forward the tube into the jejunum. The physician then pierces the jejunum wall and advances the tube till the abdominal skin level. The physician cleanses the area of incision using swab sticks and makes a stab incision onto the abdominal region over the area of jejunum. A trapping device is used through abdominal incision to pull out the tube from the jejunum wall to the abdominal wall incision. The jejunostomy tube is then strengthened and secured internally or externally by using bumper, hard bolus, disc–shaped collar, or other device to create a passage between jejunum and abdomen skin. Once thorough examination and jejunostomy tube placement is successfully accomplished, physician withdraws the instrument (scope) and patient is released shortly.

No need to code fluoroscopy as per CCI Edits.

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