Eleen Posted Wed 31st of October, 2012 18:45:03 PM
Procedure: Upper GI endoscopy
Complications: Jejunal perforation
The Endoscope was introduced through the jejunostomy, and advanced to the colon. The upper GI endoscopy was performed with difficulty due to abnormal anatomy. The patient tolerated the procedure.
Contrast was injected into the jejunostomy tube under fluoroscopic guidance to confirm position within the small bowel. A
long 0.035 inch Jagwire was advanced through the jejunosotomy tube. The jejunostomy tube was removed. The tract was
then dilated using a 33Fr, 36Fr, 39Fr, 42Fr, and 45Fr Savary dilators over the guidewire under fluoroscopic guidance. A
pediatric colonoscope was then advanced alongside the guidewire and into the jejunum. The guidewire was removed.
The pediatric colonoscope was then advanced through the jejuno-colonic anastomosis and into the transposed colon.
During attempts to advance the endoscope in a retrograde manner to the esophago-colonic anastomosis, a jejunal
perforation occured from endoscope looping. The endoscope was withdrawn and was found to be through the jejunal wall
and into the peritoneum. The site of perforation was approximately 10-15cm from the jejunostomy site. At this point, the
small bowel and peritoneum was decompressed and the endoscope was removed. IV antibiotics were administered and
preparations were made to take the patient to the OR.
- Unsuccessful attempt to reach esophago-colonic anastomosis in a retrograde manner through the
- Complicated by jejunal perforation
SuperCoder Answered Thu 01st of November, 2012 00:06:58 AM
The tract was then dilated using a 33Fr, 36Fr, 39Fr, 42Fr, and 45Fr Savary dilators over the guidewire under fluoroscopic guidance qualifies for 43248. To me it should be reported with no 52 Modifier. Do you have any special concerns? Please have your view also.
Eleen Posted Tue 06th of November, 2012 15:37:09 PM
SO sorry.I had an emgergency and just left. I apologize. My concern was that he (the physician is stating that it did not reach the Esophagus. was unsuccessful. So I would code it with just cpt 43248? Thank you
Eleen Posted Wed 14th of November, 2012 13:34:03 PM
the physician is stating that it did not reach the Esophagus. was unsuccessful. So I would code it with just cpt 43248?
SuperCoder Answered Wed 14th of November, 2012 14:52:25 PM
Yes, you are correct since it did not reach the esophagus, 43248-52 will be reported.
Eleen Posted Tue 04th of December, 2012 15:10:39 PM
since there is no code for the removal of the Jejunostomy tube, do I just code the 43248-52
The jejunostomy tube was removed.