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General Surgery Coding Alert

Reader Question:

G-Tube Is a 'Separate' Procedure

Published on Fri Jan 02, 2004

Question: The surgeon performed both large (44140) and small (44120) bowel resection and placed a gastrostomy (Stamm) tube at the same session. May I charge separately for the gastrostomy?

Arizona Subscriber Answer: CPT specifically defines gastrostomy (43830, Gastrostomy, open; without construction of gastric tube [e.g., Stamm procedure] [separate procedure]) as a "separate procedure." According to CPT conventions, a "separate procedure" is bundled to any major procedure that occurs in the same area. But placement of a gastrostomy tube occurs in a different anatomic location than bowel resection (44120, Enterectomy, resection of small intestine; single resection and anastomosis), so payers should recognize the procedure as separate and reimburse for it accordingly.
 
Surgeons may place a G-tube in lieu of an NG tube, especially when they think the patient will require long-term decompression. The tube can also be used for feeding.
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