PEG tube placement
I'm having trouble or really confusing myself with this op note. The patient had a peg tube placed the day before and it became lodged so a different physician was going to change it the next day. I've got a couple of codes that I can't decide on. Any advice?
"endoscopic replacement of the tube would be indicated and it that failed then laparoscopy for control of the open gastrotomy... a flexible endoscope was advanced through the oropharynx and down into the stomach. The stomach was insufflated and teh previous gastrotomy which was created by the peg tube was identified and ballottement of the open wound on the abdominal wall lined ip with the gastrotomy tract, therefore the abdominal wall was prepped and draped sterily. An 18 guage angiocath was advanced through the abdominal wall and through the previous gastrotomy tract. A guidewire was inserted and grasped witht he endoscope and drawn out through the oropharynx. This was affixed to a Ponsky type gastrostomy tube which was then pulled down through the esophagus and out through the abdominal wall. A silastic phalange was placed to retain the tube. The tube was trimmed and the supplied hardware was attached..."
Brooke Bierman, CPC, CPB
Coding & Billing Manager
2014 President AAPC Des Moines Chapter