J1 MAC: Hemorrhoid Artery Ligation Covered When All Else Fails

Retroactive effective Aug. 11, 2011 Palmetto GBA will reimburse services for Doppler-guided hemorrhoid artery ligation with or without retro-anal repair for Grade II or III hemorrhoids that have failed rubber band ligation or conservative treatment.

Conservative treatments include behavior modification, high fiber diets to control constipation, and hydrocortisone cream or suppositories.

Use CPT^® code 0249T Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance when submitting Medicare Part B claims to Palmetto GBA for this service.

According to CPT^® Changes: An Insider’s View 2011, it is not appropriate to submit the following CPT^® codes with 0249T: 46020, 46221, 46250-46262, 46600, 46945, 46946, 76872, 76942, and 76998.

Source: Palmetto GBA

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