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Thread: Upper endoscopy with PEG to Mickey change

  1. #1

    Default Upper endoscopy with PEG to Mickey change

    AAPC: Back to School
    Does anyone know the correct way to code an Upper Endoscopy with PEG to Mickey change?

    thanks so much!!

  2. #2
    Join Date
    Apr 2007


    Is the MD using the scope to cut/remove the internal bolster? I've been told that this can be coded two different ways...43246 or 43215 with 43760. I do enter the date of the original PEG placement to indicate when the "foreign body" with dx codes 935.2 and V55.1.

  3. #3
    Join Date
    Apr 2007
    Greater Orlando


    SuperCoder.com offers the following:
    Published in Gastroenterology Coding Alert, July 2001
    Physician notes sometimes contain references to “buttons”  PEG buttons or “Mickey” buttons. These are smaller, shorter tubes that are inserted through the tract in the skin of the abdomen that was created by a standard PEG tube, explains Michael L. Weinstein, MD, of Metropolitan Gastroenterology Group in Washington, D.C., and previous American Society for Gastrointestinal Endoscopy (ASGE) representative to the CPT Advisory Board.

    “PEG buttons are used to replace a standard PEG tube after several weeks or months when the original tube tract has matured,” Weinstein says. “Therefore you usually code it as a PEG tube replacement (43760, change of gastrostomy tube).

    “You also might see tube descriptions with ports, balloons or bumpers,” Weinstein adds. “They’re all tubes. MIC and Bard are just some of the brand names.” Placement of these shorter tubes is still coded with 43246. Changing PEG tubes of any kind should be reported with 43760.
    as viewed at: http://www.supercoder.com/articles/a...reimbursement/
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

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