CPT 49446 states that for converstion to gastro-jejunostomy tube at the time of initial gastrostomy tube placement we are to use 49446 in conjuction with 49440. CPt 49440 is for a percutaneous approach. Our doctor performed an open approach which was coded as 43830. I have received a bundling denial. My question is, is it appropriate to bill 43830 and 49446-51 separately.