tci General Surgery Coding Alert - 2010 Issue 2

READER QUESTIONS: Take Care to Select Hemorrhoid Destruction Method

Question: When billing 46930, is it appropriate also to bill 46500? California Subscriber Answer: You can bill 46930 (Destruction of internal hemorrhoid[s] by thermal energy [e.g., infrared coagulation, cautery, radiofrequency])and 46500 (Injection of sclerosing solution, hemorrhoids) together if the physician performs both procedures -- but that would be unusual. The two codes describe completely different hemorrhoid treatment methods. You wouldn't expect a physician to treat the patient using both sclerosing solution and thermal destruction on the same day. Read the op note carefully and make sure you're not interpreting some other sort of injection as a 46500 service...

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