Gastroenterology Coding Alert

Question: How should I report replacement of a "mushroom basket" for a PEG tube? I can't find a code for this in CPT.

Arizona Subscriber

Answer: A mushroom-shaped basket, or bolster, holds the PEG tube in place on the inside of the stomach wall. Sometimes the physician will need to replace this device, which involves using endoscopy to go back into the stomach. Because this procedure essentially includes a "reduced" version of PEG tube placement, you may report it with 43246-52 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube; reduced services).

Be sure to include documentation explaining the placement's reduced nature with your claim.