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.
Comments Comments
There are no comments for this article. Be the first to post a comment.
Related Articles RSS Feed
Ultrasound Guided Fine Needle Aspiration and Core BX
Viewed 6642 times since Mon, Apr 25, 2011
CPT Coding
Viewed 160 times since Fri, Aug 19, 2011
CPT for Sympathetic Nerve Block of the Inferior Hypogastric Plexus?
Viewed 5393 times since Thu, May 19, 2011
Modifier PT & 33
Viewed 2856 times since Thu, May 12, 2011
Pinch Graft to Nose
Viewed 1497 times since Tue, Nov 16, 2010
98925-98929
Viewed 1794 times since Fri, Sep 16, 2011
When To Charge Fluoroscopy (76000) With an OR Procedure
Viewed 12786 times since Mon, Dec 20, 2010
Trigger Finger Reduction
Viewed 1361 times since Tue, Nov 16, 2010
Incomplete Colonoscopy
Viewed 1525 times since Thu, Oct 20, 2011
ED procedure
Viewed 1051 times since Tue, Nov 29, 2011
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506