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Replacement and removal of peg tube

  1. #1
    Location
    Lauderdale Lakes
    Posts
    203
    Question Replacement and removal of peg tube
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    We had billed 43247 and 43246-59 for a removal and replacement of a peg tube. Medicare denied 43247. I believe we billed this incorrectly. I was hoping that someone would be able to tell me what codes should have been billed.

    report:
    The PEG bumper was removed using traction. A replacement PEG was then inserted through the existig stoma and anchored in place at 3cm. The PEG bumper borke off when I removed teh old PEG. We decided to remove the PEG bumper using a Roth net. This was snared and withdrawn via the patient's mouth.

    Impression: Successful replacement of percutaneous endoscopic gastrostomy tube and removal of percutaneous endoscopic gastrostomy tube bumper.

  2. Default
    Hey have you checked out 43760? I think that may be the correct code in this situation.

    Bob

  3. #3
    Location
    Lauderdale Lakes
    Posts
    203
    Default
    I thought about that code but it says percutaneous which means thru the skin. My doctor removed the tube by doing an EGD

  4. #4
    Default
    43247 can be used since a piece of the PEG broke off, otherwise a PEG does not constitute a foreign body. I would also code the 43760 for the PEG change as Bob suggested.

    I have also read that a diagnostic endo can be reported with the 43760 when the provider needs to determine the problem and requires assistance with the removal.
    http://www.facs.org/ahp/pubs/tips/tips1108.pdf

    Keep us posted.

  5. #5
    Location
    Lauderdale Lakes
    Posts
    203
    Default
    Thank you for that link. It helped me to understand how to code this

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