# Peg Tube Removal



## Teebow1017 (Apr 16, 2009)

GI Dr. removed a peg tube by traction with counter traction on the abdominal wall he did not insert the peg tube initially it was done in another city.  When he did the removal it was an inpatient setting.  There is not a CPT for peg removal so......any recommendations on what we can charge?   He only saw the patient for this procedure.


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## FTessaBartels (Apr 16, 2009)

*E/M service*

If he took the patient to the OR to remove the PEG under anesthesia he could use 43999 (unlisted procedure).

If this was done at bedside then it is part of an E/M service.

F Tessa Bartels, CPC, CEMC


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## mgord (Apr 22, 2009)

What if the surgeon removed the PEG tube in the office and the patient is post-op Repair of Ruptured AAA? Can he bill an unrelated E/M??


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## FTessaBartels (Apr 23, 2009)

*He didn't do the original surgery?*

If he didn't do the original surgery the post-op global period doesn't apply at all ... UNLESS ... 

If you took over ALL post op management then the original surgeon should have used the -54 modifier and you would use the exact same procedure code the surgeon used with a -55 modifier. Obviously this requires coordination with the operating surgeon so you are both on the same  page blling-wise. 

The other option would be for your doctor to just code the appropriate level E/M (there is no procedure code for removing the PEG).

If you are the same surgeon who performed the original surgery and inserted the PEG, then you can't code anything for PEG removal UNLESS you had to take the patient back to the OR to perform this under anesthesia. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## jboes41527 (Apr 28, 2009)

I'm having a similar situation in the hospital setting - Surgeons are using teh GI suite to remove peg tubes, no anesthesia involved.  I'm getting chares for supplies, room time, and maybe pharmacy items with no procedure to code.  I certainly can not code an E/M visit for an outpatient OR room.  Shouldn't these be done in the MDs office?


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