Gastroenterology Coding Alert

Question: Our gastroenterologist was called to evaluate a patient whose NG was in the esophagus and proximal stomach with clotted blood within it. He suctioned small amount of red blood which he could see, without causing any further bleeding. He mentioned that otherwise the upper third of esophagus, middle third of esophagus and lower third of esophagus were normal and removed the tube. How should I code for this nasogastric tube removal?

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Answer: There is no CPT^® code for NG tube removal, or for that matter, for gastrostomy tube removal if no new gastrostomy tube is inserted. Such minor services are included in whatever level of E/M code might be applicable for the day. CMS and its contractors do not have detailed instructions on this topic. For physician services, the work RVU reflects time and intensity, but when a coder has questions about the level of E/M service to report for the day, confer with the provider.