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Peg Tube Placement (co-surgeons)

  1. #1
    Default Peg Tube Placement (co-surgeons)
    Medical Coding Books
    Hi -

    I was wondering if anyone would be able to help me - we have two gastroenterology doctors and when doing PEG tube placements they both play a role in the placement of the PEG tube - which is not uncommon. My question is the lead doctor who is also doing an upper GI would bill hte 43246 - the one playing the role of the surgeon - would in my opinion bill the 43750. We were instructed in the past to use the 62 modifier in these situations billing the same CPT. It isn't that I can really bill a 43246 for the second doctor as he did not do the endoscopy. If anyone has any experience in this area and can tell me how they bill it - I would love to know.

  2. Default PEG's
    We bill 43246 X1 (no modifier) for the 1st physician; 43246-62 for the assistant. Our Medicare carrier on the West coast will not reimburse for assistants, so we don't bill it. As for reimbursement by private payers, it really depends upon your contracts with them.

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