# 43752 vs 44500/74340 (feeding tubes)



## Sephardic (Dec 23, 2008)

Can anyone tell the difference between these two procedures? I've been having a very difficult time trying to code these. I think because my doctors documentation is not always the best. It sounds like a 43752 because he's sticking it through his nose but he's calling it a miller-fredrick tube similar to 44500. The radiology techs put 74340 on the heading of the report. I'm tired of not knowing if I'm really coding them correctly. I have scoured my Coding alerts and can't find an answer to this.
Any information on these would be helpful. Here's an ex:

Placement of nasoduodenal Miller-Fredrick feeding tube:

Clinical history: nourishment

Findings:
Using viscus lidocaine in the left nostril and flouroscopic guidance, the Miller-Fredrick tube was manipulated through the nose, esophagus and into the stomach. I then manipulated the catheter into the duodenum and I left the tube tip in the fourth portion of the duodenum. I had to use Reglan to pass this feeding tube and it was moderately difficult.

Conclusion:
Successful nasoduodenal tube placement.




Thanks!


----------



## jdrueppel (Dec 23, 2008)

I hardly ever have to bill for the NG tube because it is bundled into my specialty (anesthesia) but here is how I understand it.  43752 / NG or OG tube is inserted only to the level of the stomach.  44050 / GI tube is placed _beyond the stomach _into the intestines.  

Per your posted documentation this would be 44500/74340 as the duodenum is the first part of the small intestines.

Hope this helps.

Julie, CPC


----------



## pharmon (Dec 23, 2008)

NG is temporary, from the nose to the stomach and it is usually short term.
G tube is percutaneous in stomach for a while and G-J is into stomach and advanced into small bowell.  J tube is percutaneous and into the jejunum.  Reading your post I would say it's a NG tube, temporary and thats what I code it as.  Some Dr's are describing the tube brand and that does get confusing to me as well.


----------

