Bobby A
Guru
We have a scenario in our textbook that we feel we would could different than the answer key. Please let us know how you would code it. Here is the scenario.
The site is an outpatient hospital. The procedure is the placement of a gastrojejunostomy catheter. for nutritional support due to nutritional deficiency.
Placement of gastrojejunostomy catheter: The patient is a 63-year-old man with extensive medical history including intracranial hemorrhage. Placement of a percutaneous gastrojejunostomy catheter was requested by Dr. A for nutritional support.
Before start of the study, the procedure was explained to the patient's wife, including the risks, complications, and alternatives. The patient's wife understood and consented to the exam.
The patient was prepped and draped int he usual sterile fashion. Using ultrasound guidance, the edge of the liver was localized. Through a previously placed nasogastric tube, the stomach was distended with air.
Using fluoroscopic guidance following administration of local anesthesia (1% lidocaine), gastropexy was performed using four Medi-Tech T-tacks at the mid to distal aspect of the stomach.
Using multiple wires and catheters, an extra stiff guidewire was ultimately placed with the tip in the proximal jejunum. A small amount of contrast was administered, which revealed adequate placement. No evidence of extravasation or other significant abnormalities was seen at the termination of the study.
IMPRESSION: Placement of a No. 14-French Shetty gastrojejunostomy catheter with the tip in the proximal jejunum as described above.
Thank you
The site is an outpatient hospital. The procedure is the placement of a gastrojejunostomy catheter. for nutritional support due to nutritional deficiency.
Placement of gastrojejunostomy catheter: The patient is a 63-year-old man with extensive medical history including intracranial hemorrhage. Placement of a percutaneous gastrojejunostomy catheter was requested by Dr. A for nutritional support.
Before start of the study, the procedure was explained to the patient's wife, including the risks, complications, and alternatives. The patient's wife understood and consented to the exam.
The patient was prepped and draped int he usual sterile fashion. Using ultrasound guidance, the edge of the liver was localized. Through a previously placed nasogastric tube, the stomach was distended with air.
Using fluoroscopic guidance following administration of local anesthesia (1% lidocaine), gastropexy was performed using four Medi-Tech T-tacks at the mid to distal aspect of the stomach.
Using multiple wires and catheters, an extra stiff guidewire was ultimately placed with the tip in the proximal jejunum. A small amount of contrast was administered, which revealed adequate placement. No evidence of extravasation or other significant abnormalities was seen at the termination of the study.
IMPRESSION: Placement of a No. 14-French Shetty gastrojejunostomy catheter with the tip in the proximal jejunum as described above.
Thank you