Question: Do we need a durable medical equipment (DME) number to bill gastrostomy tube replacements done in an office setting?
Pennsylvania Subscriber
Answer: Code 43760 (change of gastrostomy tube) is used to report a change of gastrostomy tube. You do not need a DME number to bill for a gastroenterologists services with that code. You may need a DME number to bill for the cost of the tube, which is $70. Many gastroenterology practices consider the process of getting a DME more trouble than its worth.
Because of the cost of gastrostomy tubes, all of our physicians are required to do a G-tube change either at our endoscopy center or at the outpatient facility of a hospital, says Linda Parks, MA, CPC, lead coder at Atlanta Gastroenterology Associates, a 23-physician practice. While you still cant bill extra for supplies in these settings, the facility reimbursement fee from Medicare is about $300, which more than covers the cost of the G-tube.