Gastroenterology Coding Alert

Answer: When the jejunostomy tube (also known as J-tube) is placed through a percutaneous puncture in the abdomen and under endoscopic guidance, code 44372 (small intestinal endoscopy; with placement of percutaneous jejunostomy tube) should be reported.

As you mentioned, however, there is another way to place a J-tube. When a percutaneous gastrostomy (PEG) tube has already been placed in the patient, that tube can be converted to a J-tube. A more slender tube is passed through the PEG tube, into the stomach and through the pyloric channel and duodenum into the jejunum. Code 44373 (small intestinal endoscopy; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube) should be used to report this type of procedure.

The J-tube also may need to be repositioned manually, surgically or endoscopically. Code 43761 (repositioning of the gastric feeding tube, any method, through the duodenum for enteric nutrition) should be used to report the repositioning, regardless of the method used.