General Surgery Coding Alert

1. Beginning in January, you will use 49446 (Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection[s], image documentation and report) when your physician converts a gastrostomy tube to a gastro-jejunostomy tube.

2. Another new code covers the mechanical removal of obstructive material from a gastrostomy or any other type of tube: 49460 (Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy [or other colonic] tube, any method, under fluoroscopic guidance including contrast injection[s], if performed, image documentation and report).

3. A final new code in this CPT section covers contrast injection(s) for radiological evaluation of an existing tube, including image documentation and report: 49465 (Contrast injection[s] for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy [or other colonic] tube, from a percutaneous approach including image documentation and report).

4. CPT has revised the descriptor for 44300 (Placement, enterostomy or cecostomy, tube open [e.g., for feeding or decompression] [separate procedure]) to clarify that this is not the right code for a percutaneous jejunostomy.