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Melanie Posted Thu 25th of March, 2010 15:19:15 PM

My understanding is that if the tube is removed without the use of sutures, we would have to bill this as a miscellaneous code (Medicare patient) - 49999, which I know requires documentation.

In an office setting, can we bill the office visit with a mod 25? This is BRAND NEW to me in this specialty...

Assistance is greatly appreciated... and I thank you in advance 8-)

SuperCoder Answered Fri 26th of March, 2010 06:17:26 AM

Although the PEG tube is technically a foreign object (in other words, it is not a natural part of the patient’s body), CPT classifies PEG tube removal as an incidental service and does not contain a code to describe the procedure. Therefore, the physician may report only appropriatelevel E/M codes to describe his service.
To know more check the "NCCI Policy Manual-Chpt 6-page 122"
http://www.supercoder.com/cms/cci-policy-manual/national-correct-coding-initiative-policy-manual-for-medicare-services/

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