Gastroenterology Coding Alert
Bolster Placement? Prepare to Use Outpatient E/M
Question: I’ve heard about PEG tube bolster replacement, and curious about how I should report this service. I’m looking at 43246, but not quite sure. My colleague says I should append a modifier. What is the best solution?
California Subscriber
Answer: A bolster — an external plastic apparatus — holds the PEG tube in place on the abdominal wall. If you see in your physician’s notes the replacement of a PEG tube bolster chances are the tube is functioning adequately but the bolster has become damaged and needs to be replaced. Replacing this device involves the surgeon sliding a new bolster over the G-tube without using an endoscopy to go back into the patient’s stomach.
You can report an outpatient E/M code (99201-99215).
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