# EGD through gastrostomy after PEG tube removal??



## rlmiller (Feb 16, 2012)

I have a procedure that I am not sure how to code:

EGD through gastrostomy after PEG tube removal with a removal of a pancreatic stent by snare.  The scope was inserted through the stoma and not the mouth.

I am looking at CPT code 44380 - Ileoscopy, through stoma.

Any thoughts would be greatly appreciated.


----------



## bridgettemartin (Feb 17, 2012)

44380 Ileoscopy through stoma is an exam of the small bowel.   What about 43235-52 with a note explaining only the stomach and/or duodenum were viewed?  Or look at 43234.  Or you could go with 43999 (unlisted).  I have never come across this scenario.  I'm interested to see what others have done for this.


----------



## bridgettemartin (May 30, 2013)

*EGD through stoma*

Well, I now have a similar scenario.
The indication for the EGD was melena.  My provider encounters a blind pouch in the esophagus.  He withdraws the scope.  He makes note that the patient has an existing PEG that is degraded.  He manually removes the PEG, and inserts the scope through the stoma.  He advances (retrograde) up the esophagus, but encounters a blind pouch on that end as well.  Then he pulls back, examines the stomach and duodenum.  He removes the scope and manually places a new PEG.  
I'm thinking I should just use 43999 and 43760.  Thoughts?


----------

