Home » Categories » CPT Surgery/APC Coding

Gastrostomy Tube Replacement


Question

What is the correct CPT code for replacement of a malfunctioning gastrostomy tube? Egd was performed with no evidence of gastrostomy tube in the stomach. The gastrostomy tube was removed from the subcutaneous tissue and a new PEG placed.

Answer

A gastrostomy tube replacement without an EGD would be coded to 43760 however, you have indicated that an EGD was performed, to determine if the tube was actually communicating with the stomach.  This makes the coding of this case a little more difficult.  Was the Endoscope used in the gastrostomy tube replacement?  If so 43246 would be the correct code assignment.  If the EGD was performed, the scope removed, and the tube replaced one would be tempted to code 43235 for the EGD and 43760 for the tube replacement but a CCI edit is received and it questionable whether it would be appropriate to report both codes, with a modifier 59 on 43760.  I believe you will need to make a decision between 43246 and 43235 without 43760.  They will both pay based on the same APC.  


Disclaimer: All articles intended for general consumption only and not as a recommendation for a specific situation. Readers should consult an official source (AHA, AMA, etc.) or a qualified attorney for specific legal guidance.
Attachments Attachments
There are no attachments for this article.
Related Articles RSS Feed
Medical Nutrition Therapy
Viewed 1797 times since Thu, Dec 9, 2010
Evacuation of Hematoma with Ligation of Artery
Viewed 3949 times since Thu, Jun 16, 2011
Total Hip Arthroplasty After Closed Reduction with Percutaneous Pinning
Viewed 3539 times since Thu, May 5, 2011
Dental Blocks
Viewed 13861 times since Tue, Feb 8, 2011
Dental Block
Viewed 5172 times since Fri, Sep 2, 2011
Documentation for EGD Dilatation
Viewed 1375 times since Fri, Apr 29, 2011
Flap Closure
Viewed 4907 times since Tue, Jan 31, 2012
CPT for Therapeutic Phlebotomy
Viewed 5250 times since Thu, Feb 9, 2012
Post Central Line Insertion Chest X Ray
Viewed 6324 times since Wed, Feb 23, 2011
Transbronchial bx Modifier Issue
Viewed 3468 times since Tue, Jan 10, 2012
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506