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G Tube replacement

  1. Question
    Medical Coding Books
    I have one today where the provider is changing the GTube from a long form to a low profile for the first time. Which ICD-9 would you use for this? Its not a complication and the V44.1 my provider chose isnt considered a primary dx code.

  2. #12
    East Orange, NJ
    Default Change Gtube @ home
    I have the same problem with the CPT 43760 being denied by HZN for a home visit. My Dr. was specifically called to the home for this reason. What other CPT or is there a modifier that I can use to get this covered? Any help would be greatly appreciated.
    Thank you in advance!

    Quote Originally Posted by suemt View Post
    Hi, Debra. Thanks for weighing in on this. I value your opinion, and agree with you on the V55.1 Dx.

    My question is the CPT, and I'm thinking by the description that it would be considered part of the E/M visit.

    This was not even the specific reason for the visit, it was part of a regular home visit, and the provider just had one fraction of a sentence in the note "reinserted PEG". I'm having a hard time justifying coding the 43760 with a $400 reimbursement for what sounds like the provider just popped a tube into a port. Also, the description says "change" gastronomy tube, not reinsert the one that the patient pulled out.

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