Basics of CPT code 43762 & 43763

In this article, we will learn about the CPT codes used for coding change of gastrostomy tube. Previously we had only one CPT code 43760, use for coding change of gastrostomy tube.

But, from 2019 we have two  CPT code 43762 & 43763 for change of gastrostomy tube

Read also: Know everything about Global period for Medical coders

Description of CPT code 43762 & 43763

To report gastrostomy tube change without imaging or endoscopic guidance, the medical coders have to report new CPT codes 43762 or 43763 from 1st January 2019. These codes already include the gastrostomy tube kit. Removal of the initial tube is not reported separately.

Replacement of a gastrostomy tube (GT) may be performed as a routine procedure or emergently in the event of unplanned dislodgement. A GT is a thin flexible tube or catheter with a balloon or flared tip that is inserted through the skin in the upper left quadrant of the abdomen and into the stomach. The GT may be used for nutritional support, hydration, and/or medication administration in patients with normal gastrointestinal tract function who are unable to tolerate oral food or fluids. If the tube is in place, it is first removed by deflating the balloon and placing gentle traction on the tube with one hand and applying counter traction on the abdomen with the other hand.

The GT should slide out of the gastrocutaneous tract with minimal resistance. The tract is then visually inspected and the new tube is lubricated and inserted through the ostium and into the stomach. Placement is confirmed by gastric content aspiration, air gurgle, or water/saline irrigation and the balloon is inflated (43762). In the event the new GT does not pass easily, minor revision of the gastrostomy tract may be undertaken without assistance of imagining or endoscopic guidance.

The ostium and gastrocutaneous tract are gently dilated using a probe instrument, cotton tip applicator, or hemostat to help facilitate reinsertion. A guidewire may be inserted through the tract and into the stomach. A new GT is selected, lubrication is applied, and the tube is then inserted (over the guidewire, if used), through the ostium, and into the stomach. The guidewire is removed and placement is checked by gastric aspiration, air gurgle, or water/saline irrigation and the balloon is inflated (43763).

For CPT code 43762,  the physician replaces a gastrostomy tube via percutaneous approach that does not require revision (simple) of the gastrostomy tract. If the old gastrostomy tube has been placed endoscopically, the physician must remove it by snaring and pulling it out through the mouth. A new tube is placed percutaneously through the abdominal wall via the existing tract.

For CPT code 43763, the replacement requires revision (complex). A small incision is made through the skin and fascia. A large bore needle with suture attached is passed through the incision into the lumen of the stomach. The needle is snared and the needle and suture are removed via the mouth. The gastrostomy tube is connected to the suture and passed through the mouth into the stomach and out the abdominal wall. The gastrostomy tube is sutured to the skin. No imaging or endoscopic guidance is utilized in either procedure.

43762 Replacement of gastrostomy tube, percutaneous, includes removal, when performed, without imaging or endoscopic guidance; not requiring revision of gastrostomy tract

43763 requiring revision of gastrostomy tract

CPT Code 43762 includes dilation of the gastrostomy tract (without the need for an incision) and the additional work to allow insertion of the dilation instrument. 

CPT Code 43762 is reported for replacement of a gastrostomy tube not requiring revision of the gastrostomy tract. Code 43762 includes dilation of the gastrostomy tract (without the need for an incision) and the additional work to allow insertion of the dilation instrument

CPT Code 43760 has been deleted and may not be reported for services on or after Jan 1, 2019.

For coding insertion of percutaneous gastrostomy tube placement, medical coders can report CPT code 49440 and 49441.

Supply Codes used with CPT code 43762

SG079 tape, surgical paper 1in (Micropore)
SH065 sodium chloride 0.9% flush syringe
SJ041 povidone soln (Betadine)
SK087 water, distilled
SA048 pack, minimum multi-specialty visit
SB011 drape, sterile, fenestrated 16in x 29in
SB022 gloves, non-sterile
SB028 gown, surgical, sterile
SB034 mask, surgical, with face shield
SB039 shoe covers, surgical
SB044 underpad 2ft x 3ft (Chux)
SC056 syringe 50-60ml
SC090 tube, gastrostomy
SG009 applicator, sponge-tipped
SG055 gauze, sterile 4in x 4in

Supply Codes used with CPT code 43763

SA043 pack, cleaning, surgical instruments
SA048 pack, minimum multi-specialty visit
SB011 drape, sterile, fenestrated 16in x 29in
SB012 drape, sterile, for Mayo stand
SB024 gloves, sterile
SB028 gown, surgical, sterile
SB034 mask, surgical, with face shield
SB039 shoe covers, surgical
SB042 towel, non-sterile
SB044 underpad 2ft x 3ft (Chux)
SC029 needle, 18-27g
SC051 syringe 10-12ml
SC056 syringe 50-60ml
SC090 tube, gastrostomy
SD088 guidewire
SF007 blade, surgical (Bard-Parker)
SF039 suture, silk, 2-0 to 5-0, x, fs, c
SG009 applicator, sponge-tipped
SG056 gauze, sterile 4in x 4in (10 pack uou)
SG079 tape, surgical paper 1in (Micropore)
SH047 lidocaine 1%-2% inj (Xylocaine)
SH065 sodium chloride 0.9% flush syringe
SH069 sodium chloride 0.9% irrigation (500-1000ml uou)
SJ007 bacitracin oint (0.9gm uou)
SJ009 basin, irrigation
SJ041 povidone soln (Betadine)
SJ046 silver nitrate applicator
SK087 water, distilled

RVUs and Fees for CPT code 43762