General Surgery Coding Alert

Question: What is the difference between codes 46255 and 46260? My doctor performed a hemorrhoidectomy for internal hemmorrhoids. How can I tell if a particular procedure was simple or complex?

Alabama Subscriber

Answer: When you-re determining whether to use 46255 (Hemorrhoidectomy, internal and external, simple) or 46260 (Hemorrhoidectomy, internal and external, complex or extensive), you need to turn to your surgeon and his documentation.

Based on the number and size of hemorrhoids removed, the physician must make a subjective judgment to choose 46255 or 46260. To support your coding claim, you must be sure that the physician's documentation justifies the selection of 46260 by noting the determining factors.

Pointer: Codes 46255 and 46260 apply to single or multiple removals during the same operative session. In other words, if the surgeon excises two internal hemorrhoids and one external hemorrhoid during the same operation, you should report only a single unit of 46255.