CPT® Code 49440

Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report

The CPT® Code 49440 refers to the procedure of inserting a gastrostomy tube through the skin into the stomach using a percutaneous approach, guided by fluoroscopic imaging. This technique allows for the placement of a feeding tube directly into the stomach, which is essential for patients who are unable to consume food orally due to various medical conditions. The procedure involves the use of fluoroscopy, a type of real-time imaging that helps visualize the internal structures of the body, ensuring accurate placement of the tube. The insertion can be performed using either the push technique, known as the Sacks-Vine method, or the pull technique, referred to as the Ponsky-Gauderer method. Prior to the insertion, glucagon may be administered to facilitate the procedure, and a nasogastric tube is typically placed to help insufflate the stomach. The area of insertion is prepared by cleansing the skin, and local anesthesia is applied to minimize discomfort. The entire process is meticulously documented, including the use of contrast injections to enhance imaging clarity, and a comprehensive report is generated to detail the procedure and confirm the correct positioning of the gastrostomy tube within the stomach.