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Nov 21st, 2017 - Streeter 1 

Harmonic Scapel

Proctoscopy and hemorrhoidectomy using harmonic scapel. Internal & External, 4 O'clock, 8 o"clock and 10' Oclock. Large internal and external hemorrhoids that are prolapsed.

Do I code this just like any other hemorrhoidectomy? 46260?

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Dec 18th, 2017 - ChrisW   70  1 

re: Harmonic Scapel

There are several options for excision procedures of hemorrhoids. However, the procedure described is using a scalpel, the mass would be excised with a scalpel, 46260 can be used for internal and/or external hemorrhoids with 2 or more columns/groups, If there were 2 or more columns/groups removed, I would consider reporting 46260.

46260 - Hemorrhoidectomy, internal and external, 2 or more columns/groups,

Procedure: The entire hemorrhoidal mass is excised. Bleeding is controlled by electrocautery. The surgical wound may be closed with sutures or left open to granulate.

Other methods used to perform Hemorrhoidectomy:

46930 - Cauterization

Rubber band ligation(s)
46221 - Hemorrhoidectomy, internal, by rubber band ligation(s)

46250 - Hemorrhoidectomy, external, 2 or more columns/groups

Internal and external, single column/group
46255 - Hemorrhoidectomy, internal and external, single column/group;

NOTE: Some codes include fistulectomy, be sure to select the most complete code that best describes the procedure.

TIP: Use 46999 Unlisted procedure, anus, if rubber bands were removed due to discomfort.

46930 - Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)

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