tci General Surgery Coding Alert - 2006 Issue 11

Reader Question ~ Watch Bundling Issues With Sphincterotomy

Watch Bundling Issues With SphincterotomyQuestion: Is sphincterotomy included in hemorrhoidectomy?New York Subscriber Answer: The National Correct Coding Initiative bundles 46221 (Hemorrhoidectomy, by simple ligature [e.g., rubber band]) to sphincterotomy (46080, Sphincterotomy, anal, division of sphincter [separate procedure]). This edit includes a -0- modifier indicator, meaning that you can't unbundle this code pair.Therefore, if the surgeon performs the procedures described by 46221 and 46080 at that same time, you can only report the more extensive procedure (in this case, the sphincterotomy, 46080).In addition: CPT classifies sphincterotomy (46080) as a -separate procedure,- so you cannot bill...

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