Patient comes in for change of gastrostomy tube. Physician does EGD, clips end off tube and then removes tube extraneously (not through mouth). We were coding 43246 - this is where encoder leads you due to endoscopy. This code description includes incision and really seems to be for an initial placement. It is also on the core measures hot sheet looking for antibiotic administration

Endoscopy dept. is telling us that the EGD is merely diagnostic - I did find info stating that if there is a problem replacing the tube diagnostic endo can be done and coded along with 43760 as long as documentation supports. 43760 description in Coder's Desk Reference indicates "if the old gastrostomy tube has been placed endoscopically, the physician must remove it by snaring and pulling it out through the mouth."

We have a few of these that were coded with 43246 - question - do you think we are okay changing to 43760 along with diagnostic endo?

Or should I get addendum from MD?