# Closure of gastrotomy&insert of gast.tube



## Hopp (May 14, 2008)

Hi everyone!  Wondering if someone could help with coding&modifiers.  My Doc did a closure of gastrotomy and insert.of percutaneous  endoscopic gastrostomy tube.
The codes I chose were 43870 and 43246 - just wasn't sure what modifier to use  (There were two separate incisions)  I also could not find anything re:CCI edits using these two codes together.   Please help?    Thanks


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## cmartin (May 22, 2008)

If the gastrotomy he closed was the wound from a previous gastrostomy [maybe the tube came out?] and was an open procedure, then your codes should be correct, and I would employ the -59 on the open procedure, and the -51 on the lesser procedure, assuming it was all one trip to the O.R.  This is kind of a gray area, as I understand the individual carriers have different preferences about both of these modifiers, but I think it is important to clarify that two different approaches were used.
C.Martin, CPC-GENSG


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