General Surgery Coding Alert

Question: I know there are G-tube replacement codes for procedures without imaging, but how should we report a J-tube replacement without fluoroscopic guidance?

Tennessee Subscriber

Answer: You have two options, and you might find that payers prefer one over the other. You can report either an unlisted code such as 44799 (Unlisted procedure, small intestine) or a more specific code such as 49451 (Replacement of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report) with modifier 52 (Reduced services) attached to account for the absence of guidance.

You are correct that you have code choices for G-tube replacement without guidance (43762-43763, Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance …), and that you should not use these codes for a J-tube placement.