Gastroenterology Coding Alert

Question: At our ASC, our gastroenterologist is planning to attempt banding of hemorrhoids. Can you tell me what the global period for this procedure is? Also, can you tell me how to code for this procedure so that there are no complications with billing and insurance? Will the code vary if the physician is banding more than one hemorrhoid?

Florida Subscriber

Answer: The global period for banding of hemorrhoids is 10 days. Since rubber band ligations are the most common method of banding hemorrhoids, you will need to code the procedure under 46221 (Hemorrhoidectomy, internal, by rubber band ligation[s]). When hemorrhoids are banded by rubber band ligation, the CPT® code remains the same irrespective of the number of hemorrhoids banded.

Note: Some insurance carriers might not give an approval if the procedure is being conducted at an ambulatory surgery center (ASC). They may consider this an office-based procedure. It is best to confirm if the service is covered prior to giving the green light for the procedure.