General Surgery Coding Alert

Question: A physician in another city placed a laparoscopic jejunostomy tube one month ago. A second physician, locally, attempted to remove the feeding tube in his office, but it broke off. Our surgeon then attempted to remove the broken portion in the office, but failed and had to schedule a trip to the operating room. My surgeon has suggested 43760 for this. Is this correct? Florida Subscriber Answer: Code 43760 (Change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance) describes removal and replacement of a gastrostomy tube, which has not occurred in this case. Rather, your surgeon only removed a portion of the feeding tube. CPT does not contain a specific code to describe only removal of a feeding tube. Generally, the physician would include the tube removal in any E/M service he provides at the same time. In this case, however, you might argue that 43760 with modifier 52 (Reduced services) may be appropriate. Assuming that he removed the broken portion of the feeding tube endoscopically, your best bet is more likely a foreign-body removal code, 43215 (Esophagoscopy, rigid or flexible; with removal of foreign body).