Gastroenterology Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: If our gastroenterologist inserted a PEG tube with the help of a nurse, should we code the nurse as an assistant? We will be reimbursed for the nurse's services? GAC Subscriber    
 
Answer: Coding confusion about PEG-tube placement is easily traced any procedure becomes more difficult to code when it requires two sets of hands to be completed. If a nurse or technician is helping with the percutaneous gastrostomy (PEG) tube placement, the gastroenterologist locates the desired position of the tube before handing the scope over to his assistant. It is the gastroenterologist who then makes the incision to secure the tube in place. You would code a PEG tube placed by a gastroen-terologist and a nurse with 43246 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube). The physician will receive 100 percent of the allowed amount; however, the nurse will receive no separate, additional reimbursement.