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General Surgery Coding Alert

Reader Question:

43760 Service Might Warrant Additional Codes

Published on Wed Sep 14, 2011

Question: Our surgeon sometimes changes a gastrostomy tube in the office. Should we code 43760 for the service, and can we bill separately for materials used for the new G-tube? Virginia SubscriberAnswer: Yes, 43760 (Change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance) is the appropriate code to describe the service. Regarding materials, because the procedure is in the physician office, not a facility, you may separately report the G-tube using one of the following HCPCS level II codes:B4087 -- Gastrostomy/jejunostomy tube, standard, any material, any type, eachB4088 -- ... low profile, any material, any type, each.Don't miss E/M: In addition to charging 43760 for percutaneously removing and replacing a percutaneous endoscopic gastrostomy (PEG) tube in the physician office, you should also code for any distinct, separately identifiable E/M service on the same day (such as 99213) if the surgeon documents the work. You'll need to append modifier 25 (Significant, separately [...]
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