This page addresses follow-up questions and additional information pertinent to our webinar
Coding Nonvascular Interventional Radiology Series Part 2: Urinary, Biliary, and GI Procedures.
The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: Our IR physician performed electrocautery to remove granulation tissue around a cholecystotomy tube, can this be billed?
A: Yes, although this would be an unlisted code. Code 17250 is for chemical cauterization only, so 17999 would be correct.
Q: In order to report CPT 49460, mechanical removal of obstructive material, does fluoroscopy have to be used to report the code?
A: Yes, the code has been constructed and valued to require fluoroscopy. If fluoroscopy is not used, do not report this code. Instead, report unlisted code 76499.
Q: What is the correct code when an existing gastrostomy tube is converted to a jejunostomy tube at a separate setting?
A: If an existing gastrostomy tube is converted to a jejunostomy tube at a setting separate from the initial gastrostomy tube placement, then only 49446 is reported for the conversion, because 49440 would have been reported for the initial placement of the gastrostomy tube performed at a prior setting.
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Deanna Upston, CPMA, CPC, COSC
Deanna is a consultant for The Haugen Consulting Group with over 20 years of health care industry experience. Her introduction was through medical assisting, which she enjoyed for several years. Once she was established at a surgeon’s office, she started coding their surgical cases and discovered that was her favorite part of the day. Deanna has experience working on the professional fee side of coding, audit, education and compliance serving coders and physicians. She has put together multiple education sessions for both provider and coder. She also has experience working as an analyst in which she validated the integrity of editing logic during the implementation of claim scrubbing software.