Gastroenterology Coding Alert

Hint: Use same CPT® procedural code for each provider. Are two-physician PEG tube placement coding challenges tying you down? Appending the right modifier to the procedural code, while taking into account state rules and payer policies, will free you from coding bloopers and reimbursement denial risks. Procedural example: Your gastroenterologist decides to place a percutaneous endoscopic gastrostomy (PEG) tube in a patient suffering from dysphagia that has caused weight loss over the past six months. Under sedation, your gastroenterologist uses a flexible endoscope to perform an upper gastrointestinal duodenoscopy to determine the site where the gastrostomy tube can be inserted. Another gastroenterologist places the gastrostomy tube through an incision made in the abdominal wall using the reference of the location determined by the endoscopic procedure. The gastrostomy tube is held in place by a retention disk placed along the anterior abdominal wall. Coding challenge: When two physicians perform a gastrostomy [...]