Questions regarding bundling 46230 and 46221

jfolz

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I am just looking to clarify a couple of things for myself if anyone has an opinion or info on the topic, I would appreciate any input.
If a patient presents and has 5 band (internal) ligations done at the same time as they have 3 exterior tags removed from the anal region, it doesn't seem in my mind that those two procedures should be overlapping procedures? I understand that the tags resulted from previous hemorrhoids but they are not near the internal ligation sites and they are being removed with scissors, no closure necessary. I feel like a modifier should be allowed to distinguish separate sites or something. I just don't think that by coding 46230 alone, I am capturing all of the work that the surgeon performed, just ignoring the ligation completely... Any input to help me understand this would be appreciated. Thanks!
 
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