Wiki Hemorrhoidectomy

LTibbetts

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I have an op note where the patient was having a symptomatic external hemorrhoid removed. While they were in the operating room, they also noticed a long tag superiorly and this was excised. Can I code this seperately or is it incidental to the primary procedure? Can't I use 46230-59?

Also, the provider did an internal speculum exam which revealed minor internal hemorrhoids. The person that does the pro fee is using 46600. Is that appropriate for this?

And lastly, there was an addendum done by the physician that said she noticed towards the beginning of the procedure, on the patients buttock, an area of excoriation. The etiology was not clear. It appeared to be a burn, however, the cautery had not been near that site. It was debrided and bactracin applied. Is that something that I can code as well? I came up with 16020, does that sound right? Would that need a modifer as well?
 
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