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EGD through gastrostomy after PEG tube removal??

  1. #1
    Default EGD through gastrostomy after PEG tube removal??
    Medical Coding Books
    I have a procedure that I am not sure how to code:

    EGD through gastrostomy after PEG tube removal with a removal of a pancreatic stent by snare. The scope was inserted through the stoma and not the mouth.

    I am looking at CPT code 44380 - Ileoscopy, through stoma.

    Any thoughts would be greatly appreciated.

  2. #2
    Location
    Pensacola, Florida
    Posts
    282
    Default
    44380 Ileoscopy through stoma is an exam of the small bowel. What about 43235-52 with a note explaining only the stomach and/or duodenum were viewed? Or look at 43234. Or you could go with 43999 (unlisted). I have never come across this scenario. I'm interested to see what others have done for this.
    Bridgette Martin LPN, CPC, CEMC, CGIC

  3. #3
    Location
    Pensacola, Florida
    Posts
    282
    Default EGD through stoma
    Well, I now have a similar scenario.
    The indication for the EGD was melena. My provider encounters a blind pouch in the esophagus. He withdraws the scope. He makes note that the patient has an existing PEG that is degraded. He manually removes the PEG, and inserts the scope through the stoma. He advances (retrograde) up the esophagus, but encounters a blind pouch on that end as well. Then he pulls back, examines the stomach and duodenum. He removes the scope and manually places a new PEG.
    I'm thinking I should just use 43999 and 43760. Thoughts?
    Bridgette Martin LPN, CPC, CEMC, CGIC

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