Gastroenterology Coding Alert

Question: A patient presented to a gastroenterology practice for removal of the patient’s gastrostomy tube (G-tube). Another physician placed the tube for a procedure, and the provider seeing the patient is not replacing the tube.

How should we report this service?

Kentucky Subscriber

Answer: Believe it or not, the CPT^® code set does not include a procedure code specifically for G-tube removal without replacement. In your case, you’ll simply report an appropriate evaluation and management (E/M) service code from 99202-99215 that corresponds to the medical decision making (MDM) criteria or time spent during the visit.

On the other hand, if the provider did replace the G-tube, you’d look to following code options:

• 49450 (Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, under fluoroscopic guidance including contrast injection(s), image documentation and report)
• 43762 (Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract)
• 43763 (… requiring revision of gastrostomy tract)

A provider places a G-tube in the patient’s stomach to administer medication, deliver enteral nutrition, or allow decompression.

Mike Shaughnessy, BA, CPC, Development Editor, AAPC