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Replacement of feeding jejunostomy tube

Elia Answered Thu 19th of November, 2009 19:55:12 PM

Would I use an unlisted code 49999 for this since 49451 is not appropiate or just an E&M?

malfunction of a jejunostomy tube, the tube is leaking with bile excoriation affecting the surrounding skin. The existing anchor disk
is now preventing adequate skin care. I, therefore, decided that it should be removed.

The anchor stitch and disk were removed and it was discovered that the balloon on the catheter was down
and the patient then dislodged the existing feeding tube. I decided to start over with a brand new simple Foley catheter, 18-French, which was inserted back into the tract into the bowel. Calmoseptine was
then applied to the skin and a new sterile dressing applied and the distal balloon inflated and used to anchor
the tube in place with good results.

SuperCoder Answered Fri 20th of November, 2009 12:07:32 PM

In this procedure the physician had performed a replacement of jejunostomy tube through percuteneous approach, but he did'nt performed any short of fluroscopy or contrast injection. So instead of going for an unlisted code, I would rather prefer the CPT 49451 with a 52 modifier.

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