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CPT for laparoscopic gastrostomy tube and jejunostomy tube placement

Lynn Posted Tue 07th of March, 2017 04:13:10 AM
What CPT code is correct for lap placement of this G-tube and J-tube? Using a gastrostomy kit, a needle was passed into the stomach followed by a guidewire. The tract was serially dilated, and an 18 Fr gastrostomy tube was passed over the wire. The balloon was inflated to 7 ml and the G-tube was pulled back with the 5 cm mark at the skin. The tube was secured in place and position was confirmed by aspirating gastric contents. The tube flushed easily.   The jejunostomy site was then identified approximately 25 cm from the ligament of Treitz. Four interrupted 2-0 Ethibond sutures were placed around the J-tube site and passed through the abdominal wall using the Carter-Thompson device. After making a small opening using the cautery, a needle was passed into the jejunum followed by a guidewire. The 16 Fr jejunostomy tube was passed over the wire. The balloon was inflated to 2 ml. The tube was secured in place and position was confirmed by aspirating bowel contents. The tube flushed easily.  
SuperCoder Answered Wed 08th of March, 2017 09:09:11 AM

Hi,

Our team is working on it and will get back soon,

Lynn Posted Wed 08th of March, 2017 10:58:27 AM
my doc is coding 32652,43212 with 74360 and wants to know if 44015 is correct for the lap g-tube and j-tube--if this helps. Thank you
SuperCoder Answered Fri 10th of March, 2017 04:48:46 AM

As per the documentation the procedure performed is laparoscopic and CPT 44015 is incorrect as it is an open procedure not laparoscopic. CPT for laparoscopic gastrostomy tube and jejunostomy tube placement is 43653 and 44186 respectively. But as per NCCI edits guidelines you cannot bill these two codes (i.e. 43653 and 44186) together in any circumstances. If you bill these two codes at same time CPT 43653 will get deny. So choose accordingly.

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