CPT code 49451 covers fluoroscopically guided replacement of an existing duodenostomy or jejunostomy tube through the skin. This procedure is a common interventional radiology service used to restore enteric access when feeding or drainage tubes become dislodged, blocked, or otherwise nonfunctional. Nationally, appropriate coding for 49451 affects inpatient and outpatient radiology billing, procedural tracking, and quality measurement for enteric access management.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about when tube exchanges are performed, typical settings of care, and how 49451 fits into procedural documentation and reimbursement workflows. The publication also provides national benchmarks, payer-specific coverage notes where available, and recent policy updates that influence prior authorization and medical necessity reviews.

This summary prepares clinicians, coding professionals, and health plan analysts to understand the scope of 49451, relevant billing considerations, and the operational settings where the service is most frequently delivered. Data not available in the input is noted directly in relevant sections.