# banding in office



## herrera4 (Jan 24, 2013)

Sooo... my dr started doing hemorrhoid banding in office, he received a quick reference from company he is using on billing. They state you can bill

46221-Ligation of hemorrhoid by rubber band
46600-Diagnostic Anoscopy(use -59)
45300-Proctoscopy (use -59)
A4550-Surgical Tray
office visit code

I am disagreeing completely....I can not justify using -59. Is there any circumstance where these codes could all be billed--I just billed the 46221 but I would like some reassurance...

TIA


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## sheardmd (Jan 30, 2013)

We have been doing hemorrhoid banding in the office for many years.  We have always just charged 46221.  The 46600 hits against CCI edits and there aren't any ins comp anymore that I am aware of that pay for surgical trays.  The 45300 is supposed to be the examination of the rectum and sigmoid colon and would not be appropriate.  The office visit would only be appropriate if it was for a separate reason than the hemorrhoids.  Just my two cents, not sure if that is correct or not.

Melissa


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## BEARDOG (Feb 10, 2013)

Wow. Anything to sell a product. You can only charge for the banding unless it is the first visit and the decision was made at that time to do the banding. The anoscopy is included as you cant band without doing an anoscopy and the CCI edits will kick it out. There is no way you can call an anoscopy a procto, you simply do not go that high to do a rubberband ligation.  Hope that was helpful.

Debbie, CPC,CGSC


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