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General Surgery Coding Alert

You Be the Coder:
Distinguish Internal/External Hemorrhoids

Question: Our surgeon treated a patient with two internal hemorrhoids that protruding through the anus. The treatment involved dividing the sphincter and banding the two hemorrhoids. Should we code 46221 x 2 and 46080?Washington SubscriberAnswer: You should report only one instance of 46221 (Hemorrhoidectomy, internal, by rubber band ligation[s]) for the procedure you describe.Multiple hemorrhoids: You'll notice that 46221 describes "ligation[s]," meaning that you should report only one unit of the code whether the surgeon bands one or multiple internal hemorrhoids. Sphincterotomy included: CPT® classifies 46080 (Sphincterotomy, anal, division of sphincter [separate procedure]) as a "separate procedure," which means that you can't bill for the service if the physician performs the procedure with a related procedure such as hemorrhoidectomy. Also, Correct Coding Initiative (CCI) edits bundle 46221 as a column 2 code with 46080. CCI lists the edit pair with a modifier indicator of "0," meaning that you cannot bill [...]

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