tci ED Coding & Reimbursement Alert - 2009 Issue 11

READER QUESTIONS: Split E/M from G Tube Fix

Question: The ED physician treats a patient with a malfunctioning gastrostomy tube (G tube). The patient's physician inserted the tube three weeks ago, and notes indicate that it just "popped out of place." After an exam, the physician removes the old tube and installs a new one; during the placement, he uses fluoroscopic guidance to ensure proper tube placement. How many codes can I report for this encounter? Is this all an E/M service? Massachusetts Subscriber Answer: You can code for the E/M and the G tube placement. On the claim, report the following: • 49450 (Replacement of...

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