Gastroenterology Coding Alert

Question: The gastroenterologist advanced an 18-guage needle into the patient's cecum under fluoroscopic guidance, coiling a wire into the colon. She dilated the tract, and placed an 18 French pigtail catheter just below the expected location of the fistula to the wound. The physician, then, secured and dressed the catheter. What CPT® codes apply for this scenario?

North Dakota Subscriber

Answer: In your claim, you would bill 49442 (Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic guidance including contrast injection[s], image documentation and report). A cecostomy tube, or C-tube, refers to a tube inserted into the cecum, which is the first part of the large bowel. Usually, providers use the cecostomy to administer a smallvolume phosphate enema, which they would follow up with a saline enema to quickly and completely evacuate and cleanse the large intestine, emptying through the anal opening.