Gastroenterology Coding Alert

Dont forget the 90-day global period on 46930. If your gastroenterologist destroys internal hemorrhoids with heat, youve needed to use a new-for-2009 code. Gastroenterology Coding Alert, Vol. 11, No. 2, alerted you to 46930 (Destruction of internal hemorrhoid[s] by thermal energy [e.g., infrared coagulation, cautery, radiofrequency]). What may have been a surprise is that the new code treats the procedure as major surgery: 46930 has a 90-day global period. So if your gastroenterologist performs thermal hemorrhoid destruction in stages, youll have to append a modifier or risk losing as much as $189.71. American Society for Gastrointestinal Endoscopy adviser Glenn D. Littenberg, MD,American Gastroenterology Association adviser Joel V. Brill, MD, and American College of Gastroenterology adviser Daniel C. DeMarco, MD, foresaw this problem. They recommended modifier 76 (Repeat procedure or service by same physician) in the American College of Gastroenterologys 2009 CPT update. It may be necessary to indicate that a [...]