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Gastroenterology Coding Alert

Reader Question:

Use Appropriate EGD Code For Nasogastric Tube Placement

Published on Sun Nov 25, 2012

Question: What is the CPT® code for an EGD with Naso-gastric tube placement for decompression (not PEG placement and not with fluoroscopy guidance)?   Minnesota Subscriber Answer: When your gastroenterologist places a naso-gastric tube during an EGD procedure, you will have to report this procedure with 43241 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with transendoscopic intraluminal tube or catheter placement). Many coders are confused about using 43241 for placement of a naso-gastric tube, as the insertion of the tube occurs through the nose. However, the EGD procedure your gastroenterologist conducts along with the tube placement is an aid to position the tube in the stomach. So, even though the placement of the tube occurs through the nose, you need to report 43241, as your gastroenterologist performed the EGD for the correct placement of the tube. When your gastroenterologist is placing a PEG tube, the tube is inserted percutaneously through an incision made in the wall of the stomach. Again, in this case, your gastroenterologist will be using an EGD procedure to assess where the incision in the wall of the stomach needs to be made for the correct placement of the tube. In this situation, you will be reporting the procedure with 43246 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube).

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