CPT 49446 Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report

Documentation and Coding Notes

AdSense readiness coding note: CPT 49446 should be treated as an educational starting point, not a final billing instruction. For conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report, the operative note or procedure note should clearly support the approach, anatomic site, laterality when relevant, clinical indication, and any separately reportable services.

Before submitting a claim or logging the case, compare CPT 49446 with adjacent codes in the same family, confirm current AMA CPT language, check CMS/NCCI edits, and verify payer-specific bundling rules. Modifier use should be tied to documentation rather than added only to bypass an edit.

Common audit checks for interventional radiology cases include whether the documented work matches the code descriptor, whether add-on services are separately supported, whether a global period applies, and whether ICD-10 diagnosis pairing supports medical necessity.