Wiki Replacement and removal of peg tube

[tpontillo]

We had billed 43247 and 43246-59 for a removal and replacement of a peg tube. Medicare denied 43247. I believe we billed this incorrectly. I was hoping that someone would be able to tell me what codes should have been billed.

report:
The PEG bumper was removed using traction. A replacement PEG was then inserted through the existig stoma and anchored in place at 3cm. The PEG bumper borke off when I removed teh old PEG. We decided to remove the PEG bumper using a Roth net. This was snared and withdrawn via the patient's mouth.

Impression: Successful replacement of percutaneous endoscopic gastrostomy tube and removal of percutaneous endoscopic gastrostomy tube bumper.

 

[blathrop19@gmail.com]

Hey have you checked out 43760? I think that may be the correct code in this situation.

Bob

 

[tpontillo]

I thought about that code but it says percutaneous which means thru the skin. My doctor removed the tube by doing an EGD

 

[Mojo]

43247 can be used since a piece of the PEG broke off, otherwise a PEG does not constitute a foreign body. I would also code the 43760 for the PEG change as Bob suggested.

I have also read that a diagnostic endo can be reported with the 43760 when the provider needs to determine the problem and requires assistance with the removal.
http://www.facs.org/ahp/pubs/tips/tips1108.pdf

Keep us posted.

 

[tpontillo]

Thank you for that link. It helped me to understand how to code this