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Bill Posted Fri 06th of June, 2014 10:35:57 AM

I was hoping you can help me with coding this OP report. "There appeared to be one large hemorrhoid sticking out from the right anterior position. It was removed by placing an Allis clamp on the hemorrhoid and injecting 1% lidocaine with epinephrine. We then used Metzenbaum scissors to remove it back to the internal sphincter muscle." The procedure code the surgeon gave me is "46250" for 2 or more columns/groups. How do I know if this is a column 2 hemorrhoid? By his dictation it seems to me to be just a column 1 and I should code "46255". I appreciate you help

SuperCoder Answered Fri 06th of June, 2014 16:08:49 PM

Only one hemorrhoid is there. Use 46999 for a single.

See Notes below 46250

Hemorrhoidectomy, external, 2 or more columns/groups
(For hemorrhoidectomy, external, single column/group, use 46999)

Bill Posted Mon 09th of June, 2014 08:19:46 AM

And if the hemorrhoid was internal and external, then would "46255" be appropriate? He does state that he removed it back to the internal sphincter muscle. Wouldn't that make it internal also?

SuperCoder Answered Tue 10th of June, 2014 09:58:26 AM

Very True. In this way, the physician excises confluent or mixed hemorrhoids that begin above the dentate line and extends below it (thus demonstrating attributes of both an external and internal hemorrhoid column/group).

46255 is the code to get.

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