General Surgery Coding Alert

Question: How should we code a case where the surgeon removes obstructive material from a G-tube but doesn’t replace the tube? What if the surgeon removes the tube entirely?

Illinois Subscriber

Answer: When the surgeon removes any items from a gastrostomy tube (G-tube), you’ll want to report 49460 (Mechanical removal of obstructive material from gastrostomy, duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any method, under fluoroscopic guidance including contrast injection(s), if performed, image documentation and report).

For the second part of the question, there is no procedure code to describe when the surgeon removes a tube and doesn’t replace it with anything. You’ll instead report an appropriate evaluation and management (E/M) code from 99202-99215 (Office or other outpatient visit for the evaluation and management of a new/established patient …). Which E/M code you use will depend on the documentation.