Amy Posted Wed 24th of July, 2013 12:18:17 PM
If the provider changes a PEG via endoscopy, should a reduced modifier be appended to 43246? 43246 includes making the incision. During a change, the new tube is exchanged via the already created tract.
SuperCoder Answered Mon 29th of July, 2013 10:44:25 AM
You would report only 43246 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube) in the relocation scenario you outlined above. When the surgeon performs an esophagogastroduodenoscopy (EGD) to place a new percutaneous endoscopic gastrostomy (PEG) tube, and also removes an old tube from a different location, you should report 43246. The PEG tube removal is bundled with the placement of the new tube.