Gastroenterology Coding Alert

Question: My gastroenterologist did a placement of jejunostomy feeding tube (j-tube) through a Kangaroo gastrostomy tube (g-tube). An 8 French Flex-Flo j-tube was passed through the g-tube and grasped with a three-pronged forceps with flexible video endoscope. Then it was advanced across the surgical gastrojejunal anastomosis and placed near the lower surgical anastomosis. How should I report this?

Missouri Subscriber

 
Answer: Code 44373 (Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube) should be used to report this procedure because the j-tube was inserted by passing it through a g-tube that was already in place.
 
J-tubes can also be inserted percutaneously, through an incision in the stomach under endoscopic guidance. That procedure would be reported with 44372 ( with placement of percutaneous jejunostomy tube).