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Thread: Removal of Peg (Not the surgeon that placed it)

  1. #1

    Default Removal of Peg (Not the surgeon that placed it)

    AAPC: Back to School
    How would you bill for the removal of a peg tube if you are not the surgeon that originally placed it? 43235 with V55.1 or 43247 with 936? All replies appreciated. Thank You

    Gina N, CMC

  2. #2


    Depends on the work done and where. If done in the OR, 43870. If done in the office and dr just slide it out, part of E/M. If done in the office and dr had to do a lot of work, 43870 (depending on carrier) or 43999 for CMS. CMS has a place of service issue with 43870. They want it done in the OR. V55.1 should be fine.

  3. #3
    Join Date
    Apr 2007


    By the term PEG (percutaneous endoscopic gastrostomy) tube, are you referring to a gastrostomy tube? If so, the only code you can charge for a removal is an E&M. There is no CPT code for just the removal of a G-Tube.
    Amanda Hollis, CPC, RCC, CIRCC

  4. #4


    I am still unsure about this. A part of me agrees with both responses but it does not seem approriate to bill for an E&M code when you are performing an operative procedure. You are removing a peg that was not originally placed by you or anyone in your group. For any other type of procedure that does not have a specific code, you would choose an unlisted procedure code. I would appreciate any additional feedback since again, I am struggling with this. I am going to contact Medicare to find out if they can provide any addtional information. Thank You again for responding.

    Gina Niedermaier, CMC

  5. #5
    Join Date
    Apr 2007
    Springfield Mo AAPC


    E & M code, doesn't matter if you doc didn't put it in, takes them a minute to pull a gastrostomy and they only take them to the OR if the site doesn't close on it's own, oh and your over thinking

  6. #6


    If Dr is taking a patient to the OR they are no long doing an E/M, Dr is doing a procedure which dr should be properly reimbursed for.

    Percutaneous endoscopic gastrostomy. Now you have a gastrostomy whether theres a tube there or not. If dr returns to the OR to repair the gastrostomy, I'd recommend you use code 43870 - Closure of a gastrostomy, surgical - That is what the code is for since Dr went to OR and surgically closed the gastrostomy. Code is specific to surgical so not to be confused with an E/M.

  7. #7
    Join Date
    Apr 2007
    Milwaukee WI

    Default Please post the op note

    For an accurate response to surgical coding questions, please post the scrubbed operative / procedure note.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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