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Gastroenterology Coding Alert

Reader Questions:

Look for All PEG Components

Published on Sun Mar 18, 2007

Question: My gastroenterologist worked with a surgeon, and the note says they placed a percutaneous endoscopic gastrostomy (PEG) tube, but I didn't see an endoscopic component. Should I still use 43246?


North Carolina Subscriber


Answer: Only if your gastroenterologist places a PEG tube using an upper endoscope would you use 43246 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube).  

How do you know? The operative note for 43246 will describe an upper GI endoscopy with insertion of the gastrostomy tube. As the code descriptor specifies, placement of this type involves both an endoscopic and a percutaneous (through-the-skin) component.

Your question, however, states that you didn't see an endoscopic component, so you may need to get clarification from your gastroenterologist. When the physician places a gastrostomy tube percutaneously, without an endoscopic component, select 43750 (Percutaneous placement of gastrostomy tube). The surgeon probably performed this portion.
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