# PEG tube removal w/upper GI endoscopy?



## mad_one80 (Feb 11, 2009)

I know there is no cpt code for PEG tube removal....but my physician (GI specialist)performed a PEG tube removal w/upper GI endoscopy...i usually will code 43235 but in the report he specifies that the *"PEG tube was removed using polypectomy snare technique" *which would warrant the 43251...is it possible to code a PEG tube removal by upper GI using a snare polypectomy technique? 

Any insight is appreciated!  Thank you!!


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## Anna Weaver (Feb 12, 2009)

*removal*

Have you looked at 43247? That's where I would go for removal.


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## mad_one80 (Feb 12, 2009)

Anna Weaver said:


> Have you looked at 43247? That's where I would go for removal.



I'VE READ THAT THE 43247 CAN ONLY BE USED TO RETRIEVE/REMOVE A BROKEN PORTION OF THE PEG TUBE...NOT TO JUST SIMPLY REMOVE THE PEG TUBE...
http://medicalnewswire.com/artman/publish/article_8278.shtml


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## Anna Weaver (Feb 12, 2009)

*Peg*

I just read that article and have checked a couple of other sources and you are absolutely correct. Sorry, I should have looked further in the first place. I'm not finding anything else for the removal. Sorry!!!


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## FTessaBartels (Feb 13, 2009)

*In the OR*

For our pediatric surgery practice, if we have to take the patient to the OR (or procedure room), we use the unlisted 43999 code. 

If we do this at the bedside or in the office, we just code the appropriate E/M level as per documentation.

F Tessa Bartels, CPC, CEMC


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## Leslie Jones (Mar 20, 2009)

*removal of PEG tube*

I work in a hospital and we are having this debate also.  Do you have any resources for a hospital not to code 43247 for a routine removal with EGD??  
I also agree that there is not a code for a removal with an EGD except for a broken catheter however I cannot find any rescources.  Do you have anything that states a PEG tube is NOT a foreign body.... ???


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## mad_one80 (Mar 23, 2009)

http://medicalnewswire.com/artman/pu...cle_8278.shtml 
THE LINK I POSTED ABOVE STATES THIS:


Caution: You should not report 43247 (Upper gastrointestinal endoscopy including esophagus, stomach and either the duodenum and/or jejunum as appropriate; with removal of foreign body) for PEG tube removal. *Removing a PEG tube does not generally qualify as foreign-body removal. * 

Exception: You may report 43247 if the surgeon must perform a scope to retrieve a broken portion of a PEG tube that remains in the stomach, Mueller says.


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## nlbarnes (Mar 25, 2009)

*Unlisted Procedures*

A little off the subject, but has anyone had a problem w/ Palmetto denying an unlisted procedure code because it's unlisted and supporting docs were submitted?


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## mad_one80 (Mar 26, 2009)

nlbarnes said:


> A little off the subject, but has anyone had a problem w/ Palmetto denying an unlisted procedure code because it's unlisted and supporting docs were submitted?



as far as I know...they always deny unlisted procedures...even with supporting documents! you have to appeal...and they will review each unlisted procedure, case by case! hope you have lots of patients...while dealing with palmetto!! good luck.


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