How To Use CPT Code 43752

CPT 43752 describes the insertion of a naso- or oro-gastric tube into the stomach with the guidance of a physician and fluoroscopy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 43752?

CPT 43752 can be used to describe the insertion of a naso- or oro-gastric tube into the stomach with the guidance of a physician and fluoroscopy. This procedure is typically performed to aspirate stomach contents for diagnostic or therapeutic purposes, prevent aspiration and vomiting in trauma patients, or for enteral feeding.

2. Official Description

The official description of CPT code 43752 is: ‘Naso- or oro-gastric tube placement, requiring physician’s skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report).’ It is important to note that this code should not be reported in conjunction with critical care codes, neonatal critical care codes, pediatric critical care codes, or low birth weight intensive care service codes. For percutaneous placement of a gastrostomy tube, a different code should be used. For enteric tube placement, another code should be used as well.

3. Procedure

1. The physician prepares the patient by applying Xylocaine to the nostril or throat and positioning the patient upright for better alignment of the stomach and neck.
2. A lubricant gel may be applied to the tube to desensitize the passage.
3. The physician inserts the tube through the nose or mouth and advances it under fluoroscopic guidance.
4. The patient may be asked to swallow small sips of chilled water to facilitate the progress of the tube.
5. The physician ensures that the tube has not passed through the larynx into the trachea and down into the bronchi.
6. Once the tube reaches the stomach, it is secured with adhesive tape or a tube holder.
7. The physician connects the open end of the tube to a syringe or a low-power suction pump to aspirate the contents of the stomach.
8. Any adverse reactions, such as respiratory distress or cough, may require the withdrawal of the tube.
9. The physician may also check the pH status of the stomach contents for enteral medication or feeding purposes.
10. Fluoroscopic guidance, image documentation, and a report are included in the code 43752.

4. Qualifying circumstances

CPT 43752 is performed by a physician and requires their skill and fluoroscopic guidance. It is typically used for patients who require the insertion of a naso- or oro-gastric tube for diagnostic or therapeutic purposes, aspiration prevention, or enteral feeding. It is important to note that this code should not be reported with certain critical care codes, neonatal critical care codes, pediatric critical care codes, or low birth weight intensive care service codes.

5. When to use CPT code 43752

CPT code 43752 should be used when a physician performs the insertion of a naso- or oro-gastric tube into the stomach with the guidance of fluoroscopy. It is important to follow the guidelines and not report this code with critical care codes, neonatal critical care codes, pediatric critical care codes, or low birth weight intensive care service codes.

6. Documentation requirements

To support a claim for CPT 43752, the physician must document the following information:

• Patient’s diagnosis or reason for the procedure
• Use of fluoroscopic guidance
• Date of the procedure
• Start and end time of the procedure
• Details of the procedure, including any complications or adverse reactions
• Image documentation and report

7. Billing guidelines

When billing for CPT 43752, ensure that the procedure is performed by a physician and includes fluoroscopic guidance. It is important to follow the guidelines and not report this code with certain critical care codes, neonatal critical care codes, pediatric critical care codes, or low birth weight intensive care service codes. It is also important to note that the code includes fluoroscopy, image documentation, and a report.

8. Historical information

CPT 43752 was added to the Current Procedural Terminology system on January 1, 2001. There was a code change on January 1, 2004, which modified the description of the procedure.

9. Examples

1. A physician inserts a naso-gastric tube into the stomach of a patient with gastrointestinal bleeding, using fluoroscopic guidance to ensure proper placement.
2. A physician performs the insertion of an oro-gastric tube into the stomach of a trauma patient to prevent aspiration and vomiting, utilizing fluoroscopy for guidance.
3. A physician inserts a naso-gastric tube into the stomach of a patient with a suspected drug overdose, using fluoroscopic guidance to drain the stomach contents and remove the harmful substance.
4. A physician performs the insertion of an oro-gastric tube into the stomach of a patient requiring enteral feeding, utilizing fluoroscopy to ensure proper placement and secure the tube.
5. A physician inserts a naso-gastric tube into the stomach of a patient for diagnostic purposes, using fluoroscopic guidance to aspirate stomach contents for analysis.
6. A physician performs the insertion of an oro-gastric tube into the stomach of a patient with a gastrointestinal obstruction, utilizing fluoroscopy to guide the placement and relieve the obstruction.
7. A physician inserts a naso-gastric tube into the stomach of a patient undergoing surgery, using fluoroscopic guidance to decompress the stomach and prevent aspiration during the procedure.
8. A physician performs the insertion of an oro-gastric tube into the stomach of a patient with a feeding intolerance, utilizing fluoroscopy to ensure proper placement and initiate enteral feeding.
9. A physician inserts a naso-gastric tube into the stomach of a patient with a suspected bowel obstruction, using fluoroscopic guidance to decompress the stomach and relieve symptoms.