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General Surgery Coding Alert

Reader Questions:

43246: PEG Tube Removal, Replacement, Relocation

Published on Fri May 13, 2011

Question: Sometimes our surgeon removes a previously-placed PEG tube during an office visit. Occasionally, the surgeon will percutaneously remove and replace a PEG tube during an office visit. When the surgeon needs to relocate the PEG tube, it involves an EGD to place a new tube in a different location, plus removing the old tube. Based on the reader question "43246 Includes Removal" in General Surgery Coding Alert Vol. 13 No. 4, I would like a clarification -- how should we code each of these scenarios?Ohio SubscriberAnswer: You would report only 43246 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube) in the relocation scenario you outlined above -- which was the scenario addressed in the reader question. When the surgeon performs an esophagogastroduodenoscopy (EGD) to place a new percutaneous endoscopic gastrostomy (PEG) tube, and also removes an old tube [...]
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