Ask Dr. Z

I have a case in which they had a GJ, and they repositioned it and now it is a G-tube. I have code 49465 for the injection, but I am not sure about the repositioning. "Dysphagia displacement - gastrojejunostomy tube injection, gastrostomy tube repositioning. Person with need for long-term enteral nutrition. Tube was pulled back and then readvanced. Please evaluate positioning. Impression: 1) Contrast material was injected into the indwelling 14 French Shetty gastrojejunostomy feeding tube, confirming appropriate positioning of the distal tip in the proximal jejunum. The catheter is patent and amenable to immediate use. 2) Contrast material was injected into the indwelling pigtail gastrostomy. The gastrostomy tube had migrated into the proximal small bowel. For this reason, the catheter was slightly retracted and repositioned into the gastric lumen."