SPECIALTYCODING
Networker
Has anyone ever coded this procedure before?
A transverse incision was made in the skin. A large bore
sheath was advanced through the skin into the gastric lumen. A wire was
advanced down the sheath and grasped with a snare. It was pulled out
through the oropharynx, hooked to the PEG, and the PEG was pulled down
through the oropharynx and out through the abdominal wall. It was trimmed
to a short size. A snare was passed down the newly placed peg. The snare
was opened. The scope was passed through the open snare, and the scope
itself was snared. I then passed the snared scope down to the bowel beyond
the ligament of Treitz, confirmed with x-ray. I dumped off a 450 0.03 Jag
wire and left it well beyond the ligament of Treitz, pulled back the scope,
opened the snare, snared the wire, pulled the scope out the oropharynx,
pulled the wire out through the PEG and pulled the oral end of the wire out
from the mouth and out through the PEG. I then threaded a Boston
Scientific PEG/PEG-J tube over wire under fluoroscopy and confirmed it
beyond the ligament of Treitz with contrast injection
A transverse incision was made in the skin. A large bore
sheath was advanced through the skin into the gastric lumen. A wire was
advanced down the sheath and grasped with a snare. It was pulled out
through the oropharynx, hooked to the PEG, and the PEG was pulled down
through the oropharynx and out through the abdominal wall. It was trimmed
to a short size. A snare was passed down the newly placed peg. The snare
was opened. The scope was passed through the open snare, and the scope
itself was snared. I then passed the snared scope down to the bowel beyond
the ligament of Treitz, confirmed with x-ray. I dumped off a 450 0.03 Jag
wire and left it well beyond the ligament of Treitz, pulled back the scope,
opened the snare, snared the wire, pulled the scope out the oropharynx,
pulled the wire out through the PEG and pulled the oral end of the wire out
from the mouth and out through the PEG. I then threaded a Boston
Scientific PEG/PEG-J tube over wire under fluoroscopy and confirmed it
beyond the ligament of Treitz with contrast injection
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