Ask Dr. Z

"The abdomen including the PEG were prepped and draped sterilely. I made transverse incision including the gastrocutaneous tract around 5 cm in length. This was carried down to subcutaneous tissue following the course of the PEG. The adjacent tissues were not inflamed or infected appearing. The PEG was partially within the stomach and within the abdominal wall along the tract, no evidence of perforation or communication into the abdomen. The PEG was then removed. The opening into the stomach was then closed using a 2-0 Vicryl suture in figure-of-eight fashion. Fascial was then closed using running 2-0 Vicryl suture transversely. Wound was irrigated and sutures were used to close the dermis." FINDINGS: PEG bumper wedged within the gastrocutaneous tract, no infection. PROCEDURE: Abdominal wall exploration and PEG removal. Coders are in disagreement whether this is 43500, or 43870, or 43999. Please advise.