# Gastrostomy tube and Jejunostomy tube



## nc_coder (Nov 5, 2009)

Can anyone tell me how this should be coded?  We have a couple of things in mind.  Also, can someone explain why both would be done at the same time?  From the description in the notes, both were put in for feeding.  This was an open procedure.  Not percutaneous.  The Gtube was placed first then the Jtube.
Thanks for the help and clarification.


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## j.berkshire (Nov 9, 2009)

Without seeing the actual procedure report, I can suggest that sometimes a PEG is converted to a PEJ.  The patient has a PEG in place and the physician performs an endoscopy to the jejunum.  A jejunostomy tube is advanced through the previously placed G-tube.  Then the J-tube is pulled through the scope and advanced into the jejunum.  This is sometimes done for better nutritional support.  The code for this conversion is 44373.


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## nc_coder (Nov 9, 2009)

The gastrostomy tube and the jejunostomy tube were placed in the same session (operation).  The gasto first then the jejuno.  An these were open procedures.


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## sgochoco (Nov 12, 2009)

What is the clinical indication for both tubes being placed at the same session ? Are they not both feeding tubes ?


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