G-tube with J-tube extension

ChristineA

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My physician did an Egd where he examined esophagus, stomach and duodenum and jejunum then he dictated that a PEG tube with J tube extension was seen extending into the small bowel. In view of the age of the tube, we decided to replace it.
The old balloon was deflated and the old PEG tube was pulled out in one piece under guidance from the endoscopy. Then a new PEG tube with J extension was introduced into the stomach. A snare was used to catch the extension and under guidance of the endoscope, it was pushed into the jejunum then a resolution clip was deployed to attach the suture at the tip of the tube with the jejunal mucosa.
Any sugg. on how to bill this?? Is it just a PEG tube change? Thanks for any help anyone can provide payor is medicare
 
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