# EGD w/removal PEG and conversion to GJ



## judyp53 (Mar 19, 2009)

Looking for help with this scenario: video endoscope introduced per os and directed under direct visualization. Esophagus appeared normal in it's entirety as did stomach and proximal duodenum. The existing PEG was visualized with the J going transpylorically. The J was pulled, the PEG was cut at the skin level and taken out the mouth using basket snare. Endoscope replaced showing gastric depth of 2.5 cm, therefore a 16x2.5x30 cm length skin level GJ button was sewn into the stoma and directed with both endoscopic care initially into the pylorus and then rat-tooth was used to push down into the duodenum. From there, fluoroscopic dye was used to show good C-loop position. Water-soluble dye was used. Balloon insufflated with 6 cc water.

I am escpecially interested in the coding of the fluoroscopy - thoughts?

Thanks!
Judy


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## heart123 (Mar 20, 2009)

are you talking 71090-26


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## Anna Weaver (Mar 23, 2009)

*peg to gj*



judyp53 said:


> Looking for help with this scenario: video endoscope introduced per os and directed under direct visualization. Esophagus appeared normal in it's entirety as did stomach and proximal duodenum. The existing PEG was visualized with the J going transpylorically. The J was pulled, the PEG was cut at the skin level and taken out the mouth using basket snare. Endoscope replaced showing gastric depth of 2.5 cm, therefore a 16x2.5x30 cm length skin level GJ button was sewn into the stoma and directed with both endoscopic care initially into the pylorus and then rat-tooth was used to push down into the duodenum. From there, fluoroscopic dye was used to show good C-loop position. Water-soluble dye was used. Balloon insufflated with 6 cc water.
> 
> I am escpecially interested in the coding of the fluoroscopy - thoughts?
> 
> ...



Look at 49446 conversion of gastrostomy to gastro-jejunostomy, percutaneous under fluoroscopic guidance including contrast. See if this might help, and fluoro is inclusive.


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