91ÊÓƵAnswers Your Coding Questions
We have a patient in the hospital who has a G-tube that the patient says is too small—medications are difficult to give, and feeds are too slow. Our doctor exchanged the tube at the bedside. Would this be considered just a visit and not a procedure?
ASGE members may submit coding inquiries electronically to codingquestions@asge.org. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the 91ÊÓƵmember’s name and ID number. Only questions will be accepted and not reports. Below are two questions that could be beneficial to your practice.
Question #1
We have a patient in the hospital who has a G-tube that the patient says is too small—medications are difficult to give, and feeds are too slow. Our doctor exchanged the tube at the bedside. Would this be considered just a visit and not a procedure?
Answer
Since your doctor did an exchange, CPT code 43762 can be billed. You would bill it as a visit if the tube was removed, not replaced.
Question #2
One of our physicians performed an EGD for food impaction. This procedure took over five hours. The physician would like to include billing for an extended procedure. Is there a CPT code we can use for that?
Answer
Modifier 22 (increased procedural service) would be added to the foreign body removal CPT code. The endoscopy report will have to be sent when the explanation of benefits is received for the payer to determine additional payment. Be sure that time spent and complexity are documented clearly within the procedure note.