46930 vs. 46255

molisa

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Our surgeon uses the terminology "CO2 laser excision" of hemorrhoids. I'm understanding that as a cutting away with the laser being utilized as a scalpel, but someone else feels it's destruction because the laser was used in general.
Opinions? Thanks!
 

Lujanwj

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I agree with you. The laser is just a tool that the DR used to excise the lesion. There also should be a biopsy to accompany the excision. If it was destroyed, there wouldn't be a specimen for biopsy. That code set, in my opinion, is mess up and contradicts itself. 46900 starts with destruction and 46922 end with Surgical excision. However, I think the kicker is the DX being a Hemorrhoid so I would stick to the code that best matches CPT verbiage of what is being done which is a hemorrhoidectomy.

Just a thought
 

molisa

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Thanks for your response. I'm having this "laser excision" a lot, sometimes with skin lesions that sound more like a shave to me with path sent also. Hospital always wants destruction any time that thing is turned on! I appreciate your opinion - it's good to know I'm totally off base :)
 
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