# Colonoscopy with cauterizaton of Hemorrhoids



## jdibble (May 9, 2011)

Hi all - if someone can help with this scenario that would be great!  Surgeon performs a diagnostic colonoscpopy on a Medicare patient who has dx of rectal bleeding.  During the colonoscopy he finds internal prolapsable hemorrhoids and removes them by cauterization.  How would you code this?  Can both the colonoscopy and the destruction be coded - 45378 and 46930 - or would I code a colonoscopy with lesion removal - 45383?

Your help is greatly appreciated!


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## blathrop19@gmail.com (May 9, 2011)

The 45378 and 46930 codes can be coded together per the CMS http://www.cms.gov/NationalCorrectCodInitEd/01_overview.asp#TopOfPage  . You shouldn't need a 59 modifier with this either.

Bob


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## jdibble (May 9, 2011)

Thanks so much Bob!


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## surgonc87 (May 9, 2011)

you get around the same amount of RVu doing it either way. I would report 45383 instead of two codes, that may get into more trouble with payment.
MS


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## DEDGE CGIC (May 13, 2011)

We regularly perform IRC hemorroid removal in our practice (46930) the big issue we have run into however with Medicare is they will not pay for services with a diagnosis code of 455.0 Internal Hemorroids. We have discovered though by using the patients indicators of the hemorroids, such as rectal bleeding 569.3. We have recieved imbursement from Medicare for this proceedure.


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