Gastroenterology Coding Alert

Question: Our surgeon excised a column of hemorrhoids that began above the dentate line but extended below it. How should I code this procedure?

Michigan Subscriber

Answer: Report the excision of this single hemorrhoid column and code the removal procedure under 46255 (Hemorrhoidectomy, internal and external, single column/group). If the case involved multiple columns, you would turn to 46260 (… 2 or more columns/groups). Here’s why.

To understand why you’d report internal and external hemorrhoids, we need to fully understand the dentate line. That’s the line that differentiates internal and external hemorrhoids. The hemorrhoids above the line are considered internal, and those below the line are considered external. With that in mind, we know that your provider was dealing with both internal and external hemorrhoids. Excisions code according to columns, so as the provider excised one column and there were internal and external hemorrhoids present, 46255 would be the correct code to use.