AHA Coding Clinic® for HCPCS - 2024 Issue 1; Ask the Editor

Internal hemorrhoidectomy only

A patient with constipation presented for a right posterior and left posterior excisional hemorrhoidectomy. The rectal area was irrigated once hard stool was removed. It was revealed that the patient had engorged internal hemorrhoids, with the largest in the right posterior and left posterior columns. There was also a very mild anterior internal hemorrhoid as well.Right and left posterior excisional hemorrhoidectomies were performed. For the right posterior hemorrhoid, a 2-0 Vicryl figure of eight was placed just cephalad to the hemorrhoidal column and tied, excising the hemorrhoid in its entirety. Using the same 2-0 Vicryl, a running locking closure of the mucosa was performed. The left posterior hemorrhoid was resected and the mucosa was closed in the same fashion. The anterior hemorrhoid was too small to be resected so it was left in situ. The procedure was complete.For facility reporting, what is the correct code assignment for a right and left internal hemorrhoidectomy? ...

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