Gastroenterology Coding Alert

Question: How do I report a PEG-to-J-tube conversion?

Ohio Subscriber

Answer: In most cases, the appropriate code for converting a percutaneous gastrostomy (PEG) tube to a jejunostomy tube (also referred to as a j-tube) is 44373 (Small intestinal endoscopy ...; with conversion of percutaneous gastrostomy tube to percutaneous jejunostomy tube).
 
In conversions of this type, the PEG tube is already in place. The gastroenterologist then passes a more slender tube through the PEG tube, into the stomach and through the pyloric channel and duodenum into the jejunum.
 
If the physician must reposition the jejunostomy tube -- manually, surgically or endoscopically -- you may report 43761 (Repositioning of the gastric feeding tube, any method, through the duodenum for enteric nutrition).
 
Less frequently, the physician may also place a J-tube through a percutaneous puncture in the abdomen and under endoscopic guidance instead of through a PEG tube. report this procedure with 44372 (Small intestinal endoscopy ...; with placement of percutaneous jejunostomy tube).