General Surgery Coding Alert

Question: Our surgeon excised a column of hemorrhoids that begins above the denate line but extends below it. How should we code the procedure?>

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Answer: The denate line differentiates internal and hemorrhoids, with those above the line classified as internal, and those below the line classified as external. That means the case you describe involves a column of mixed internal and external hemorrhoids.

Do this: Report the excision of this single hemorrhoid column as 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).

According to CPT^® guidelines, three different positions in the anal canal will form anal columns: right posterior, right anterior, and left lateral positions. When your physician removes more than one hemorrhoid by a non-rubber band technique, you need to concentrate on the number of columns from which the hemorrhoids have been removed rather than the actual number of hemorrhoids.