Hemorrhoidectomy and anoplasty Help!!!!!

Lindseywingate1990

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Lake View, Alabama
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I am coding this OP report I am new to ASC coding.... Need help with which procedure to code

Procedure: excisional anal fissure or ulcer, hemorrhoidectomy, sphincterotomy, and anoplasty

The patient was placed in prone jackknife position.......rectum was gently dialated. Patient was noted to have posterior chronic anal fissure with associated scarring and and distal tags. There were left and right posteriorlateral associated hemrhoids as well. There were internal and external and finally a smaller right group. The posterior anal ulcer and associated tags were excised with a elliptical incision and the skin was pulled up. The incision was then closed transversly. The left and right posterolateral genitalia and later the right anterior hemorrhoid all removed in similar fashion with elliptical incision and in each case once saw the hemmrroid were carefully excised from the sphincter muscle. The partial thickness distal internal sphincterotomy was performed with a cutting cautery.




I coded 46260 the interal and external hemmrrhoidectomy 2 or more columns... the sphincterotomy and the anoplasty and excisional anal fissure were all global.... Did I code the wrong one?? I'm confused on which one I should code when everything is global.
 
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Nashville
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I would use 46261 which is hemorrhoidectomy with fissurectomy which is what he describes.

46700 is anoplasty for stricture. Is that what he did it for?

That's how I would code it.
 
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Hi, I would like to know the CPT code for Hemorrhoidectomy, internal and external, complex or extensive with lateral internal sphincterotomy.
Can anyone help?
Thank you
 
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