Gastroenterology Coding Alert

Gastroenterologists won't turn to ligation in every hemorrhoid case. Although less frequently performed, CPT provides codes to describe other methods of removing internal hemorrhoids. These include:

- 46500--Injection of sclerosing solution, hemorrhoids. In this procedure, the gastroenterologist injects a sclerosing solution into the submucosa of the rectal wall under the hemorrhoid. Once again, this reduces blood flow to the area and causes the hemorrhoid to shrink.

- 46934--Destruction of hemorrhoids, any method; internal. This is a -catchall- code to describe any method of destruction other than ligature or sclerosing solution. Such methods could include the use of electrical current or infrared radiation.

Because the descriptors for both 46500 and 46934 specify -hemorrhoids- (plural), you should report these codes only once per session, regardless of how many hemorrhoids the gastroenterologist treats.