General Surgery Coding Alert
G-Tube Is a 'Separate' Procedure
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? 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.
Arizona Subscriber
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.
General Surgery Coding Alert
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Modifier -22 or Unlisted-Procedure Code?
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Bill On-Call Visits as 'Established'
Question: Our physician is "on-call" for another surgeon. If he sees one of the surgeon's [...] - Reader Question:
Same-Day Observation/Discharge = 99234-99236
Question: A patient presented to the ED complaining of dizziness and nausea following a minor [...] - Reader Question:
Use Split-Thickness Codes for Keratinocytes
Question: How should I code for harvesting of keratinocytes for skin grafts?
Texas Subscriber
Answer: The appropriate [...] - Reader Question:
G-Tube Is a 'Separate' Procedure
Question: The surgeon performed both large (44140) and small (44120) bowel resection and placed a [...] - Reader Question:
Medicare Won't Recognize 'After Hours'
Question: A Medicare patient knocked on the door on a Friday when the office was [...] - Reader Question:
Select 99220 and 99217 for Multiday Observation
Question: Our surgeon treated a patient in the emergency department, and he admitted the patient [...] - Reader Question:
Report Initial Hospital Care for Admits Only
Question: I was recently called into the hospital to take over the care of a [...] - Reader Question:
Three Steps for Excision/Biopsy Coding
Question: Our surgeon obtained a partial incisional biopsy followed by excision of the same lesion. [...] - Correction
The January issue of General Surgery Coding Alert ("Have Skin Grafts Got You Guessing?" p. [...]
