Summary & Overview
CPT 49441: Percutaneous Fluoroscopic Jejunostomy or Duodenostomy Tube Placement
CPT code 49441 represents the percutaneous, fluoroscopic-guided insertion of a jejunostomy or duodenostomy feeding tube. This enteral access procedure is used to deliver nutrition directly into the small intestine for patients at high risk of aspiration or those who have had a gastrectomy. Nationally, the code is important for hospitals and interventional radiology services that manage complex nutritional needs and aim to reduce aspiration-related morbidity.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes coverage and reimbursement considerations across major payers, typical sites of service, and clinical indications that drive utilization.
Readers will learn the clinical context for using CPT code 49441, how the procedure is commonly performed and where it is delivered, and what benchmarks and policy updates to monitor for payer coverage. The content provides a concise operational overview useful for billing teams, clinical managers, and radiology departments to align coding practice with clinical workflows and payer expectations. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 49441 describes the percutaneous, fluoroscopic-guided insertion of a jejunostomy or duodenostomy tube through the skin. This procedure places a feeding tube into the small intestine (jejunum or duodenum) to provide enteral nutrition for patients at increased risk of aspiration or who have had a gastrectomy.
-
Service type: Image-guided percutaneous enteral tube placement
-
Typical site of service: Hospital outpatient department or interventional radiology suite; may also occur in inpatient settings depending on clinical context
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who requires enteral nutrition distal to the stomach, often because of chronic aspiration risk, prior gastrectomy, or gastric outlet obstruction. The patient is referred from an inpatient surgical or medical service or from outpatient gastroenterology for placement of a percutaneous radiologic jejunostomy/duodenostomy tube under fluoroscopic guidance (CPT 49441). Pre-procedure workflow includes review of prior imaging, coagulation status correction if needed, informed consent, and NPO instructions. In the interventional radiology suite, conscious sedation or monitored anesthesia care is provided; local skin anesthesia and sterile technique are used. Under fluoroscopy, contrast is instilled to opacify bowel, and the jejunal or duodenal loop is accessed percutaneously with needle and wire, followed by dilation and placement of the feeding tube. Post-procedure, tube position is confirmed radiographically and by aspiration/contrast, instructions for tube care and enteral feeding initiation are provided, and the patient is monitored briefly for bleeding, peritonitis, or tube malfunction before discharge to the ward or home with outpatient nursing follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting the physician or non-physician practitioner component separate from the technical component (if technically billed by facility under ). |