perianal lesion

codedog

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Please help if you can. What codes would you use ?

DX- INTERNAL HEMORROHOID, external skin tag and perianal ulceration
Procedure :Hemmorrhoid ligation and excision of perianal lesions x3

Findings-One anterior midline anal skin tag, two right and left posterioe superficial ulcertations, and internal hemorrhoids ligated

A digital rectal exam was performed which demonstrated a right p0sterior anal papilla. A hill fergerson anal retractor was used to examine the distal rectal mucosa. The mucosa appeared redundant and showed some evidence of friability for mucosal prolapase. An anterior skin tag was excised with bovie electrocautery and the wound was left open. Two superficial ulcerations located on the perianal skin were excised .
Hemostasis was achieved with bovie electrocautery. A perianal block was created with exparel and thrombin gel foam inserted into the anal canal.

46922?46220? does any one see the ligation part ?
thanks for your time
 
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