General Surgery Coding Alert

Question: When billing 46930, is it appropriate also to bill 46500? California Subscriber Answer: You can bill 46930 (Destruction of internal hemorrhoid[s] by thermal energy [e.g., infrared coagulation, cautery, radiofrequency])and 46500 (Injection of sclerosing solution, hemorrhoids) together if the physician performs both procedures -- but that would be unusual. The two codes describe completely different hemorrhoid treatment methods. You wouldn't expect a physician to treat the patient using both sclerosing solution and thermal destruction on the same day. Read the op note carefully and make sure you're not interpreting some other sort of injection as a 46500 service. That said, Correct Coding Initiative (CCI) and CPT instruction do not restrict reporting together 46930 and46500 if the physician performs both services for the same patient on the same day.