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
Strapping
Viewed 732 times since Fri, Nov 2, 2012
Arterial Puncture Charge
Viewed 3935 times since Mon, May 28, 2012
Foley Catheter Placement - Outpatient Therapuetics
Viewed 4734 times since Fri, Feb 11, 2011
Post Central Line Insertion Chest X Ray
Viewed 5797 times since Wed, Feb 23, 2011
Can Opener Capsulotomy for Cataract Extraction
Viewed 2656 times since Tue, Nov 16, 2010
PICC Line Insertion
Viewed 7277 times since Wed, Nov 23, 2011
Removal of Biliary Stent via Gastroscopy
Viewed 21245 times since Tue, Nov 16, 2010
Treatment Patella FX
Viewed 4387 times since Thu, May 3, 2012
Cystoscopy with Retrograde Pyelogram bilateral
Viewed 6505 times since Wed, Nov 21, 2012
Dental Block
Viewed 4851 times since Fri, Sep 2, 2011
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506