# Replacement and removal of peg tube



## tpontillo (Mar 23, 2011)

We had billed 43247 and 43246-59 for a removal and replacement of a peg tube.  Medicare denied 43247.  I believe we billed this incorrectly.  I was hoping that someone would be able to tell me what codes should have been billed. 

report:
The PEG bumper was removed using traction.  A replacement PEG was then inserted through the existig stoma and anchored in place at 3cm.  The PEG bumper borke off when I removed teh old PEG.  We decided to remove the PEG bumper using a Roth net.  This was snared and withdrawn via the patient's mouth.  

Impression: Successful replacement of percutaneous endoscopic gastrostomy tube and removal of percutaneous endoscopic gastrostomy tube bumper.


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## blathrop19@gmail.com (Mar 23, 2011)

Hey have you checked out 43760? I think that may be the correct code in this situation.

Bob


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## tpontillo (Mar 23, 2011)

I thought about that code but it says percutaneous which means thru the skin.  My doctor removed the tube by doing an EGD


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## Mojo (Mar 23, 2011)

43247 can be used since a piece of the PEG broke off, otherwise a PEG does not constitute a foreign body. I would also code the 43760 for the PEG change as Bob suggested. 

I have also read that a diagnostic endo can be reported with the 43760 when the provider needs to determine the problem and requires assistance with the removal.  
http://www.facs.org/ahp/pubs/tips/tips1108.pdf

Keep us posted.


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## tpontillo (Mar 24, 2011)

Thank you for that link.  It helped me to understand how to code this


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