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Thread: Asc?

  1. #1
    Join Date
    Apr 2007

    Default Asc?

    AAPC: Back to School
    Have anyone ever seen this type of procedure? If so, what code are you all using ???
    I am leaning towards 46930 but the word destruction makes me second guess.



    OPERATION/PROCEDURE PERFORMED: Examination under anesthesia and

    ANESTHESIA: General endotracheal anesthesia.



    SPECIMENS: Included a right anterior hemorrhoid and a right posterior

    INDICATIONS FOR PROCEDURE: The patient is a 65-year-old male with
    symptomatic hemorrhoids. He now desires repair. He has acknowledged the
    risks and benefits, including the specific risks of anal pain and fecal
    incontinence, bleeding, infection, and recurrent hemorrhoids. He
    understands these risks and is willing to proceed.

    OPERATIVE FINDINGS: Two right-sided hemorrhoids that were internal.

    DESCRIPTION OF PROCEDURE: After informed consent was signed, the patient
    was brought to the operating room and placed in the supine position.
    Sequential compression devices were placed on his lower extremities
    bilaterally. Antibiotics were not indicated for this procedure. After
    general endotracheal anesthesia was induced without difficulty, and he was
    then flipped supine. A brief pause was then made to note the patient's
    name, site of surgery, and any patient allergies.

    After the pause, we did an examination under anesthesia where we noted 2
    internal hemorrhoids on the right. There were no other findings in the
    anal canal that were suspicious.

    We then directed our attention to the right posterior hemorrhoid. We
    injected lidocaine at the base of this and made an incision using
    electrocautery below this. We took care to avoid injury to the anal
    sphincter during this process. We then took the incision down in wedge
    fashion using a Ligasure down to the base of the hemorrhoid. We then
    sewed this up at the mucosal level using 2-0 chromic, leaving the most
    distal aspect of the incision or that area just outside the anal canal
    open for adequate drainage. We then proceeded to do the exact same
    procedure to the right anterior bundle using a ligasure until close. Once
    this was all completed, we inserted dibucaine ointment and a Gelfoam into
    the anus, and the patient was awakened from anesthesia. The specimens
    were sent off for pathologic review. Hemostasis was achieved throughout.

  2. #2

    Smile cpc

    I'm in agreement with 46930 as in this case the "destruction" is done by electrocautery.

    Good luck, looking forward to seeing if there is any add'l responses and if they agree

  3. #3

    Default cpc cont

    Also I was leaning toward 46260

  4. #4
    Join Date
    Apr 2007

    Default Asc ?

    Thanks for your response dcook. I am waiting on the physician to come in so that I can query him. Once I get an answer I will post it.


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