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Contrast injection -NG Tube - Under fluoroscopic guidance water

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Shirleybala

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Under fluoroscopic guidance water soluble contrast material was carefully injected thro the indwelling naso-gastric tube.

How to code this procedure
 
Unless the contrast injection thru NG tube was for the purpose of obtaining a small bowel series which would be 74251
 
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 The physician injects contrast via a percutaneous approach for the radiological evaluation of existing tubes (gastrostomy, duodenostomy, jejunostomy, gastrojejunostomy, or cecostomy). Image documentation and report are included in this procedure.
49465- is injection procedure for percutaneous gastrostomy and not for naso gastric tube
So only iam having the doubt
 
Geesh, I really need to stop answering questions late at night because that is the second time I have overlooked a crucial piece of info!
In the November 2003 CPT Asst on pg 14 this same question was asked and AMA stated that it was appropriate to use CPT 49424 & 76080. I attached a copy of the page just in case you wanted it.
 

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Hi Anita,


We use 49424/76080 for GJ tube contrast injection until the code 49465 updated. As you told, the concept is correct for 2003, but now we have seperate codes for GJ tubes, so I feel 49465 is appropriate.

Your thoughts pls

Elamathi CPC
 
Elamathi,
As Shirley pointed out, CPT 49465 specifically states Percutaneous approach and since the NG tube is not a percutaneously placed g-tube then I would still utilize 49424/76080 as instructed in 2003. The only way I would feel comfortable billing CPT 49465 for a NG tube would be if the report specifically dictates that the injection itself was performed via a percutaneous approach.
 
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