2025 CPT code 49441
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Insertion of duodenostomy or jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation, and report.
Modifiers may be applicable to indicate specific circumstances, such as increased procedural services (22), multiple procedures (51), reduced services (52), or other situations as defined in the CPT manual.
Medical necessity must be clearly documented. This typically includes conditions preventing oral intake or necessitating bypassing a portion of the digestive tract, such as dysphagia, esophageal stricture, gastrectomy, or intestinal obstruction.
The physician is responsible for prepping and anesthetizing the patient, performing the percutaneous insertion under fluoroscopic guidance, securing the tube, and managing post-procedure care.
In simple words: A feeding tube is inserted through the skin into the small intestine using x-ray guidance. This allows for feeding patients who cannot eat normally, especially those at risk of choking or who have had their stomach removed.
This procedure involves the percutaneous insertion of a jejunostomy or duodenostomy tube using fluoroscopic guidance. It includes contrast injection(s), image documentation, and a report. This method is often used for patients at higher risk of aspiration or those who have undergone gastrectomy.The process involves prepping and anesthetizing the patient, then using fluoroscopy to guide a needle puncture into the abdominal wall. A guidewire is passed through the needle, the needle is removed, and a dilator is used to expand the tract. The feeding tube is then inserted and secured into the small intestine, typically the jejunum or duodenum, and stitched in place. Dressings are applied after instrument removal.
Example 1: A patient with a history of stroke and dysphagia (difficulty swallowing) requires a feeding tube for nutritional support. A jejunostomy tube is placed percutaneously using fluoroscopic guidance (49441)., A patient with a recent gastrectomy (surgical removal of the stomach) requires a feeding access point. A duodenostomy tube is placed under fluoroscopic guidance to bypass the missing stomach (49441)., A patient with a pancreatic tumor causing blockage of the digestive tract needs nutritional support.A jejunostomy tube is inserted percutaneously using fluoroscopic imaging (49441) to provide feeding access beyond the blockage.
Documentation should include the medical necessity for the procedure (e.g., inability to swallow, gastrectomy), details of the procedure including fluoroscopic guidance and contrast injection(s), type of tube placed (jejunostomy or duodenostomy), location of insertion, and any complications encountered.
- Revenue Code: P6C - MINOR PROCEDURES - OTHER (MEDICARE FEE SCHEDULE)
- Specialties:Gastroenterology, Interventional Radiology, Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center