Gastroenterology Coding Alert

Question: How should I report the placement of a PEJ tube?

Missouri Subscriber

Answer: It depends on whether or not a PEG tube was already present.

If the patient already has a PEG tube placed and the gastroenterologist is converting it to a PEJ tube so it passes into the distal duodenum, report 44373 (Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube).

However, when there is no PEG tube present in the patient, use 44372 (Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, not including ileum; with placement of percutaneous jejunostomy tube).

Keep in mind: In addition to PEJ and PEG tubes, there are also "Miller-Abbott" tubes, which are longer than the other two tubes and are often used when there is some sort of obstruction. When the gastroenterologist places a Miller-Abbott tube, report 44500 (Introduction of long gastrointestinal tube [e.g., Miller-Abbott] [separate procedure]). The Miller-Abbott tube is not generally used for enteral feeding.