Ask Dr. Z

How would you code repositioning of a GJ tube? I saw your answer to a previous question where you recommended 49465 because the catheter was only pulled back slightly and "nothing like trying to advance a catheter from the stomach into the jejunum". In my case, they had to advance the catheter into the distal duodenum.

"The retention balloon on the existing catheter was deflated, with a total of 2.5 mL of water removed from the balloon. The existing GJ tube was then advanced through the stoma and the retention balloon was injected with 4 mL of water without resistance. 10 mL of contrast was then injected through the gastrostomy port and lateral fluoroscopic image was obtained, which showed retention balloon within the stomach and no leakage of contrast outside of the stomach. 5 mL of contrast was then injected through the jejunostomy port to confirm appropriate catheter position. Both the jejunostomy and gastrostomy ports were then flushed with water. The patient tolerated the procedure well and there were no immediate complications."