# Mic-Key Button Replacement



## LeaHarris (Aug 2, 2017)

So my provider completed the following procedure and I am not sure the proper code:

G12.21 ALS (amyotrophic lateral sclerosis) (HCC)  (primary encounter diagnosis) - Under sterile conditions the Mic-Key button was replaced today without difficulty.  20F 3cm tube inserted and balloon inflated with 5 mL sterile water (recommended 5mL, max 10 mL).  60mL sterile water then infused through the G-tube site without difficulty, and without subsequent leakage from around tube site.  Tube with more play, no longer retracted into the stomach wall with the pressure of balloon.  Much more comfortable per patient

The current code I am looking at is 43760 -- change of gastronomy tube, per-cutaneous w/o imaging or endoscopic guidance but when I read the detailed description it seems more complicated than what my provider did in office.

Further description indicates: 
The physician changes a gastrostomy tube via per-cutaneous approach. No imaging or endoscopic guidance is utilized. If the old gastrostomy tube has been placed endoscopically, the physician must remove it by snaring and pulling it out through the mouth. A new tube is placed subcutaneously through the abdominal wall via the existing tract. A small incision is made through the skin and fascia. A large bore needle with suture attached is passed through the incision into the lumen of the stomach. The needle is snared and the needle and suture are removed via the mouth. The gastrostomy tube is connected to the suture and passed through the mouth into the stomach and out the abdominal wall. The gastrostomy tube is sutured to the skin. 

Thank you!!


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## cgaston (Aug 3, 2017)

That is the code we use.  
My short description is "the provider pulls out the existing tube and "re-threads" it though the existing tract".


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