Radiology Coding Alert

Question: I have documentation of an enteroclysis study for a patient with intermittent partial small bowel obstruction. The radiologist placed a jejunal tube under fluoroscopic guidance and performed the enteroclysis exam. He documented focal distal ileal stricture. Which codes should I report?

Maine Subscriber

Answer: The key to properly reporting this enteroclysis study -- which allows the radiologist to examine the small intestine -- is to code each component separately.

Tube placement: The jejunal tube placement merits 44500 (Introduction of long gastrointestinal tube [e.g., Miller-Abbott] [separate procedure]).

RS&I: For the fluoroscopic guidance required for placement, CPT instructs you to report 74340 (Introduction of long gastrointestinal tube [e.g., Miller-Abbott], including multiple fluoroscopies and films, radiological supervision and interpretation).

Study: You may report the enteroclysis study separately using 74251 (Radiologic examination, small intestine, includes multiple serial films; via enteroclysis tube).

ICD-9: For the diagnosis, choose 560.89 (Other specified intestinal obstruction).

-- The answers for You Be the Coder and Reader Questions were reviewed by radiology coding expert Jackie Miller, RHIA, CCS-P, CPC, vice president of product development for Coding Metrix in Powder Springs, Ga.