tci General Surgery Coding Alert - 2022 Issue Q4

Reader Questions: Don’t Let Endoscopy Fool You

Question: Using a nasogastric tube, the surgeon inflated the abdomen, then punctured the patient’s abdominal wall for access. Using fluoroscopic guidance, the surgeon serially dilated the GI tract and inserted a GI tube using pull technique. After inflating the balloon, the surgeon confirmed intragastric placement using contrast injection. How should we code this? Mississippi Subscriber Answer: The best choice for this scenario is 49440 (Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report). Here’s why: The procedure description you provided makes no mention of endoscopy, so you should not use 43246...

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