I have a case where a standard PEG procedure with EGD assistance (43246) was performed, but a laparoscope was inserted simultaneously in the abdomen to view the stomach during the procedure. This is a pediatric surgeon and he explained that he prefers to do that with his patients to avoid puncturing other organs in the process of the tube insertion. I've cross-posted to the peds thread as well. Has anyone encountered this? How did you bill? My providers are billing 43246 and 49320, but I'm not sure that a 49320 is justified. I've considered an unlisted code. Any help is appreciated.
This type of procedure is described here: https://www.sages.org/meetings/annu...eg-by-surgeons-with-basic-laparoscopy-skills/
This type of procedure is described here: https://www.sages.org/meetings/annu...eg-by-surgeons-with-basic-laparoscopy-skills/
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