CPT® Code 49452

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

The CPT® Code 49452 refers to the procedure for the replacement of a gastrojejunostomy tube, which is performed percutaneously under fluoroscopic guidance. This procedure is essential in situations where the existing tube may have been accidentally dislodged or removed, necessitating its replacement to ensure continued nutritional support or drainage. During the procedure, the healthcare provider inspects and cleanses the tract of the gastrojejunostomy tube to prepare it for the new tube insertion. The use of fluoroscopic guidance is critical, as it allows for real-time imaging of the tube placement, ensuring accuracy and safety throughout the process. Contrast media is injected into the tract to enhance visibility during imaging, allowing the physician to assess the tract's condition and confirm the correct placement of the replacement tube. The replacement tube is then carefully inserted over a guidewire, which facilitates its passage into the stomach or other targeted areas. Once in place, the tube is secured with retention devices internally and is also affixed externally to the skin to prevent further dislodgment. This comprehensive approach, which includes image documentation and a written report, ensures that the procedure is thoroughly recorded and that the tube is positioned correctly for optimal function.