Radiology Coding Alert

Question: Which CPT code should I report when the radiologist injects Gastrografin through an indwelling gastrostomy tube to confirm the tube's tip lies within the body of the stomach and check for extravasation?

Answer: The proper code for this service is 49465 (Contrast injection[s] for radiological evaluation of existing gastrostomy, duodenostomy, jejunostomy, gastrojejunostomy, or cecostomy [or other colonic] tube, from a percutaneous approach including image documentation and report).

Remember this code includes the injection and the imaging. For example, the clinical example in CPT Changes 2008: An Insider's View includes injecting the contrast medium through the catheter and verifying the proper positioning under fluoroscopic imaging.

Tip: Gastrografin (diatrizoate meglumine and diatrizoate sodium solution) is a contrast agent, which is administered orally for a stomach exam. The provider may choose Gastrografin when barium sulfate would be dangerous for the patient.