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Gastroenterology Coding Alert

You Be the Coder:

Sometimes You May Need a Separate E/M Code

Published on Fri Mar 26, 2010

Question: My gastroenterologist treated a nursing home patient in the emergency department with a displaced G-tube and evidence of dehydration. She performed a detailed history and physical exam, ordered lab tests, and administered IV fluids for rehydration. Examination of the tube showed a significant clog. The gastroenterologist reviewed the lab tests, rehydrated the patient, and changed the Gtube. Which codes should I report on the claim? Ohio Subscriber Answer: On the claim, you should report: 43760 (Change of gastrostomy tube) for the tube replacement 99284 (Emergency department visit for the evaluation and management of a patient, which requires these three key components: a detailed history; a detailed examination; and medical decision-making of moderate complexity) for the E/M service modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) appended to 99284 to show that the E/M service [...]
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