CPT® Code 49460

Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including contrast injection(s), if performed, image documentation and report

The procedure described by CPT® Code 49460 involves the mechanical removal of obstructive material from various types of feeding tubes, including gastrostomy, duodenostomy, jejunostomy, gastrojejunostomy, cecostomy, or other colonic tubes. This intervention is necessary when these tubes become obstructed, which can impede the delivery of nutrition or medication to patients who rely on these feeding methods. The procedure is performed under fluoroscopic guidance, which allows for real-time imaging of the tube's position and the obstructive material. The use of fluoroscopy is critical as it ensures that the physician can accurately visualize the anatomy and the obstruction, facilitating effective removal. During the procedure, the physician may utilize various methods to break up the obstructive material, including the use of wires and guidewires. If these initial attempts are unsuccessful, a mechanical device may be employed to assist in dislodging the obstruction. The process may require multiple passes of the wire to ensure that all obstructive material is effectively cleared and pushed into the stomach or intestine. Once the obstruction is fully resolved, the catheter is flushed to ensure patency, and contrast media may be injected to confirm that the tube is functioning correctly. Continuous radiographic imaging is utilized throughout the procedure, and documentation of the images, along with a written report, is included as part of the procedure's requirements. This comprehensive approach ensures that the procedure is performed safely and effectively, with thorough documentation for medical records and billing purposes.