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2025 CPT code 49452

Replacement of a gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation, and report.

If a new tube is placed via a separate percutaneous access site, it is considered an initial placement and coded using 49440-49442.

Modifiers may be applicable. Refer to current CPT guidelines for appropriate usage.

Medical necessity for GJ tube replacement is established when the existing tube is no longer functional, dislodged, blocked, or leaking, and the patient requires continued enteral feeding.

The physician prepares and anesthetizes the patient. Using fluoroscopy, the physician removes the existing gastrojejunostomy tube and inserts a new one through the existing percutaneous site. Contrast is injected to confirm proper placement and tube patency. After the procedure, the physician applies sterile dressings.

IMPORTANT:For replacement of a jejunostomy tube only, use 49451.

In simple words: A doctor replaces a feeding tube that goes through the skin into the stomach and small intestine.Using x-ray, the old tube is removed, and a new one is put in its place.Dye is injected to make sure the new tube is in the right spot.

Under fluoroscopic guidance, the physician replaces an existing gastro-jejunostomy (GJ) tube percutaneously. The existing tube may be removed using fluoroscopy. Then, using a guidewire, a new GJ tube is advanced into position through the abdominal wall via the existing percutaneous site. Contrast injections are used to ensure proper placement of the tube in the jejunum and stomach. The procedure includes image documentation and a report.

Example 1: A patient with a malfunctioning GJ tube presents for tube replacement., A patient's GJ tube has become dislodged, necessitating replacement., A patient requires a new GJ tube due to blockage or leakage of the existing tube.

Documentation should include the medical necessity for the procedure, details of the tube replacement process, confirmation of placement via contrast injection, and any complications encountered.

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