# Pph  hemorrhoid



## codedog (Nov 16, 2010)

Doc  did  a  PPH     cpt code  (46947 )  ,but diagnosis code  says   external  hemorrhoids and grade 3  hemorrhoid,  What  doesS the GRADE 3  MEAN, internal hemorrhoid I HOPE, because 46947 is the sonly  stapler method that I know of stapling . Woul d  it be 455.2 ?


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## preserene (Nov 16, 2010)

here we go::
 The only difference is that internal hemorrhoids originate from deeper within the rectum/anus, while piles (the old-fashioned term for external hemorrhoids) originate at or very close to the anal opening.



Both external and internal hemorrhoids have their severity measured by a grading system, although the criteria applied for the grading system apply *more to internal hemorrhoids *than external ones.
•    Grade 1 internal hemorrhoids aren’t prolapsed.  In simpler terms, the hemorrhoid doesn’t protrude from the anus at all.
•    Grade 2 internal hemorrhoids protrude from the anus after passing a bowel motion, but they go back inside without help.
•    Grade 3 internal hemorrhoids are like Grade 2 internal hemorrhoids, but they need a bit of help getting back in.  
•    Grade 4 internal hemorrhoids protrude all the time and no amount of encouragement will help them go inside.

The more involved procedure is internal hemorrhoid  in your case. So the external hemorrhoid  goes as a part of the Int hem procedure. Coding for internal hemorrhoid is ideal


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