Coding for PEG and PEJ Tubes

Percutaneous Endoscopic Gastrostomy (PEG) and Percutaneous Jejunostomy (PEJ) tubes rank among the most commonly miscoded procedures by GI practices. Every practice should carefully review the rules for coding these procedures:

43246 Upper endoscopy with placement of a PEG.
43246-62 When two physicians perform the placement of the PEG, both bill code 43246 with the 62 modifier. Both physicians must dictate their own procedure report. Medicare payment for each physician is 62.5 percent of the Medicare physician fee schedule for the procedure.
43247 Endoscopic removal of the PEG tube.
43760 The manual change of the PEG tube, without imaging or endoscopic guidance.
43761 Repositioning a gastric feeding tube, through the duodenum for enteric nutrition.
E/M Service The manual removal of the PEG tube without replacement.

Here are the coding rules related to PEJ tubes:

44372 Small intestinal endoscopy with placement of a PEJ.
44373 Small intestinal endoscopy with conversion of a PEG to a PEJ.