How To Use CPT Code 49452

CPT 49452 describes the replacement of a gastro-jejunostomy tube using fluoroscopic guidance, including contrast injection(s), image documentation, and a report. 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 49452?

CPT 49452 can be used to describe the replacement of a gastro-jejunostomy tube through the skin, guided by fluoroscopy. This procedure is performed when the existing tube becomes dislodged or is no longer functioning properly. The provider uses contrast injections, image documentation, and a report to ensure proper placement of the new tube.

2. Official Description

The official description of CPT code 49452 is: ‘Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation, and report.’

3. Procedure

1. The provider uses fluoroscopic guidance to remove the existing gastro-jejunostomy tube through the skin, pulling it free through the gastrostomy tract.
2. If necessary, the provider releases the retention device, such as a balloon, used to secure the tube.
3. A guide wire is then used to advance a new gastro-jejunostomy tube into position through the abdominal wall, using the existing percutaneous site.
4. The provider secures the retention device internally and may inject contrast at each step to ensure proper placement of the tube in the jejunum and stomach.
5. After the procedure is completed, the provider applies sterile dressings.

4. Qualifying circumstances

This procedure is performed on patients who require the replacement of a gastro-jejunostomy tube. The provider must use fluoroscopic guidance and perform the procedure percutaneously. The use of contrast injections, image documentation, and a report is also required.

5. When to use CPT code 49452

CPT code 49452 should be used when a provider performs the replacement of a gastro-jejunostomy tube using fluoroscopic guidance, contrast injections, image documentation, and a report. It is important to ensure that all the necessary components of the procedure are met before reporting this code.

6. Documentation requirements

To support a claim for CPT 49452, the provider must document the following information:

• Reason for the replacement of the gastro-jejunostomy tube
• Use of fluoroscopic guidance and contrast injections
• Image documentation of the procedure
• Report detailing the steps taken and the outcome of the procedure

7. Billing guidelines

When billing for CPT 49452, ensure that the procedure meets all the necessary requirements, including the use of fluoroscopic guidance, contrast injections, image documentation, and a report. It is important to follow any additional guidelines provided by payers to ensure accurate and timely reimbursement.

8. Historical information

CPT 49452 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates to the code since its addition.

9. Examples

1. A patient presents with a dislodged gastro-jejunostomy tube, and the provider performs a replacement procedure using fluoroscopic guidance, contrast injections, image documentation, and a report.
2. During a routine check-up, it is discovered that the patient’s gastro-jejunostomy tube is no longer functioning properly. The provider performs a replacement procedure using fluoroscopic guidance, contrast injections, image documentation, and a report.
3. A patient with a gastro-jejunostomy tube experiences complications, and the provider determines that a replacement procedure is necessary. The procedure is performed using fluoroscopic guidance, contrast injections, image documentation, and a report.
4. Following an imaging study, it is determined that the patient’s gastro-jejunostomy tube needs to be replaced. The provider performs the replacement procedure using fluoroscopic guidance, contrast injections, image documentation, and a report.
5. A patient with a gastro-jejunostomy tube reports discomfort and requests a replacement. The provider performs the procedure using fluoroscopic guidance, contrast injections, image documentation, and a report.