Insertion of percutaneous endoscopic gastrostomy (PEG)

Created Jun 2012
Updated Jul 2014
Reviewed Jul 2016

Query

Should a gastroscopy procedure code be assigned in addition to 30481-00 [870] Initial insertion of percutaneous endoscopic gastrostomy [PEG] tube?

We thought the code 30481-00 [870] included the endoscope. However our Paediatric surgeon advised that the PEG can be inserted with or without an endoscope, so it should be coded separately if done. Our Paediatric coder has been coding both, does NZCA agree?

Response

Techniques for inserting a percutaneous gastrostomy tube have changed over time, and can now be performed via laparoscopy or fluoroscopy instead of endoscopically.

As ACHI only contains procedure codes for initial and repeat insertion of percutaneous endoscopic gastrostomy [PEG] tube it is advised that an additional procedure may be assigned to further specify the approach.  Free text should be used on the code description to add specificity. For example:

Percutaneous gastrostomy tube inserted via OGD

30481-00 [870]  Initial insertion of percutaneous endoscopic (OGD) gastrostomy [PEG] tube

Percutaneous gastrostomy tube inserted via laparoscopy

30481-00 [870]  Initial insertion of percutaneous gastrostomy [PEG] tube
30390-00 [984]  Laparoscopy

Percutaneous gastrostomy tube inserted via fluoroscopy

30481-00 [870]  Initial insertion of percutaneous gastrostomy [PEG] tube using flourosocpy

References
Medscape reference: Percutaneous Gastrostomy and Jejunostomy

Applied Medical Technology, Inc: Mini ONER Buttons and Other Gastrostomy Products 

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