General Surgery Coding Alert

Reader Questions:

43246 Includes Removal

Question: How should we bill for an EGD with PEG removal?Pennsylvania SubscriberAnswer: The correct code for an esophagogastroduodenoscopy (EGD) with removal of a percutaneous endoscopic gastrostomy (PEG) tube is 43246 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube).The procedure you describe involves your surgeon replacing a feeding tube that runs through the patient's skin straight into the stomach. The removal of the old PEG tube is incidental to its replacement, so you only need the one code.
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