Gastroenterology Coding Alert
PEG Tube Replacement Depends on Removal
Question: We just started to do PEG tube replacement and removal in our practice. Which code should we use for replacement, and which code should we report for removal?
Mississippi Subscriber
Answer: When your gastroenterologist replaces a percutaneous gastrostomy (PEG) tube, report 43760 (Change of gastrostomy tube).
When the physician removes the PEG tube, the code depends on how she does so. If the doctor uses a scope for safety reasons or because a piece of the tube broke off in the stomach, you would use 43247 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with removal of foreign body).
If the physician removes the tube manually, you can only bill the service as an E/M code (for example, 99201-99215). There is no CPT code for manual removal.
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