# Replacement of dislodged jejunostomy tube



## alisonbee (Mar 23, 2010)

*Looking for opinions for coding this procedure:* 
The former feeding jejunostomy tube site was triply prepped and appropriately draped.   With lubrication, a 12 French red Robinson catheter was gently reinserted into the former J-tube tract without difficulty.   It was affixed to the skin temporarily.   Placement of the tube was verified via portable abdominal x-ray with injection of 60 mL half-strength Gastrografin.    When it was confirmed that the feeding tube was in the jejunum, the tube itself was affixed to the skin.   The skin surrounding the J-tube was again triply prepped and appropriately draped in a sterile fashion.  The surrounding skin was infiltrated with 1% Lidocaine.  It was determined that adequate anesthesia was obtained.   A single suture of 2-0 nylon was placed in the skin and the drain was affixed without difficulty.   A jejunostomy tube easily flushed and was productive of bilious drainage.   A dry sterile dressing was applied.

Thoughts include:  
Code 49451 is almost appropriate; however it speaks of using fluoroscopy – which was not utilized in this case.  Placement was confirmed with a portable abdominal film with contrast.  

Do you think 49999 would be most appropriate in this case?


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## sam_son  (Mar 24, 2010)

We will not use 49999 for this procedure. 
we can use 49451 which is more appropriate.


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