# Internal & External Hemorrhoidectomy 46255



## SUEV (Aug 31, 2009)

Could someone please tell me when code 46255 can be used?  It's titled "Hemorrhoidectomy, internal and external, simple".  Can this code be used when removing both internal hemorrhoids and external hemorrhoids or does this mean that the single hemorrhoid removed has to be comprised of both internal and external components?    
Thanks,
Sue


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## Anna Weaver (Aug 31, 2009)

*hemorrhoidectomy*



SUEV said:


> Could someone please tell me when code 46255 can be used?  It's titled "Hemorrhoidectomy, internal and external, simple".  Can this code be used when removing both internal hemorrhoids and external hemorrhoids or does this mean that the single hemorrhoid removed has to be comprised of both internal and external components?
> Thanks,
> Sue



Here's the description of the procedure:

CPT Lay Descriptions 
10021 - 19396	30000 - 39561	50010 - 59871	70010 - 79445	90281 - 99607
20000 - 29907	40490 - 49906	60000 - 69990	80047 - 89356	0016T - 0198T


46255 

The physician performs excision of internal and external hemorrhoids. The physician explores the anal canal and identifies the hemorrhoid column. An incision is made in the rectal mucosa around the hemorrhoids and the lesions are dissected from the underlying sphincter muscles and removed. The incisions are closed with sutures.


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## SUEV (Sep 1, 2009)

*But wait, there's more!*

Yes, that's the description that the reference I use (Encoderpro by Ingenix) has.  But there's also an illustration that accompanies the description that states "Report 46255 for simple removal, often by elastic banding of both internal and external."  The description sounds like it has to be a combo hemorrhoid, but the illustration sounds like the code could be used for multiple individual hemorrhoids.  Am I interpreting the instructions wrong?


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## Anna Weaver (Sep 2, 2009)

*hemorrhoidectomy*



SUEV said:


> Yes, that's the description that the reference I use (Encoderpro by Ingenix) has.  But there's also an illustration that accompanies the description that states "Report 46255 for simple removal, often by elastic banding of both internal and external."  The description sounds like it has to be a combo hemorrhoid, but the illustration sounds like the code could be used for multiple individual hemorrhoids.  Am I interpreting the instructions wrong?



There's another code for ligature 46221 so I don't know what they are referring too in the illustration. I would use the 46255 for exactly what the description says any incision/excision. If you do a ligature I would use 46221. I believe if you are doing both ligation and excision, I would just code the excision code. According to Procedural coding professional 2009 "Only the more extensive procedure necessary to accomplish the hemorrhoidectomy is reported." 
These are just my thoughts. Anyone else?


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