Gastrostomy tube placement was performed for enteral nutrition support.  The patient presented with dysphagia, documented by a videofluoroscopic swallow study, and was determined to be at high risk for aspiration pneumonia.  Indications for gastrostomy tube placement included inadequate oral intake resulting in weight loss and malnutrition, along with the inability to safely maintain adequate hydration.  The procedure was performed under conscious sedation, using either a percutaneous endoscopic gastrostomy PEG or surgical gastrostomy technique.  Prior to the procedure, informed consent was obtained, and the risks and benefits were thoroughly explained to the patient andor family.  The procedure site was prepped and draped in a sterile fashion.  Placement was confirmed by fluoroscopy or direct visualization, and the tube was secured.  Post-procedure, the patient tolerated the procedure well.  Initial gastrostomy tube feeding orders were prescribed, and patient education regarding gastrostomy tube care, feeding administration, and potential complications such as infection, leakage, or dislodgement, was provided.  Follow-up with a registered dietitian for ongoing nutritional management and assessment is scheduled.  This procedure is coded using CPT codes such as 43246, 43247, or 49440 depending on the specific technique utilized, and ICD-10 codes such as E86.0 or relevant underlying conditions necessitating the tube placement.  Documentation supports medical necessity for the gastrostomy tube placement and ensures appropriate reimbursement.