• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
  • Important Note: We will be performing a scheduled maintenance on 1st November 2020. The site will be offline from 7:30PM (MT) till midnight. We apologize for any inconvenience this may cause.

anal papilla & hemorrhoid--HELP

beck627

Networker
Messages
37
Best answers
0
Hi Everyone~
I am a seasoned coder but very new to general surgery coding and I got bit by code 46221 so now I am a little nervous. My MD is stating I should bill 46211 for this surgery which I don't think is right.

(condensed)
Anal papilla r posterior quadrant was sharply excised w/scissors and sutured. Anal canal polyp at anterior midline was also sharply excised with scissors and then cauterized. Defect was closed w/3-0 chronic and bites were taken to also ligate an associated internal hemorrhoid.

I was thinking I should bill 46945 & 46922-51. What do you think?

All help is greatly appreciated!!!
 

amitjoshi4

Guru
Messages
113
Best answers
0
Hi Everyone~
I am a seasoned coder but very new to general surgery coding and I got bit by code 46221 so now I am a little nervous. My MD is stating I should bill 46211 for this surgery which I don't think is right.

(condensed)
Anal papilla r posterior quadrant was sharply excised w/scissors and sutured. Anal canal polyp at anterior midline was also sharply excised with scissors and then cauterized. Defect was closed w/3-0 chronic and bites were taken to also ligate an associated internal hemorrhoid.

I was thinking I should bill 46945 & 46922-51. What do you think?

All help is greatly appreciated!!!

Hi,

The reported coded should be 46922 only. Since there is a single papilla and 46220 covers it which itself is a separate procedure. It will be not reported. 46221 is correct for Ligation of internal hemorrhoid. The documentation says" also ligate an associated internal hemorrhoid".If multiple internal hemorohids were present , then 46945 would have been correct. Look at the cdr of 46221 : "The physician performs hemorrhoidectomy by ligation of an internal hemorrhoid. The physician identifies the internal hemorrhoid. The hemorrhoid is ligated at its base usually with a rubber band. The hemorrhoid tissue is allowed to slough over time." The final codes should be 46922 and 46221.

Thank You
 
Last edited:

beck627

Networker
Messages
37
Best answers
0
I am so glad I asked! I completely missed the "s" on that code. These hemorroid procedures are deceptively tricky! Thanks for your help!
 
Top