How To Use CPT Code 46260

CPT 46260 describes the excision of two or more internal and external hemorrhoids or hemorrhoid groups. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 46260?

CPT 46260 can be used to describe the excision of two or more internal and external hemorrhoids or hemorrhoid groups. This code is used when the provider removes these hemorrhoids during a surgical procedure.

2. Official Description

The official description of CPT code 46260 is: ‘Hemorrhoidectomy, internal and external, 2 or more columns/groups.’

3. Procedure

1. The provider prepares the patient for the procedure and ensures they are appropriately prepped and anesthetized.
2. The provider locates the groups of external hemorrhoids near the anal canal and internal hemorrhoids inside the anus.
3. The provider accesses the hemorrhoids by retracting the anal canal.
4. The provider incises the mucosa around the hemorrhoid column and separates the hemorrhoid from the surrounding tissues.
5. The provider removes the hemorrhoid through the anal canal.
6. The provider controls bleeding from the excision site and irrigates the area with antibiotics.
7. The provider closes the incision with sutures or may leave the operative site open for self-healing of the wound.
8. The provider repeats this procedure for all hemorrhoids found.

4. Qualifying circumstances

Patients eligible to undergo CPT 46260 are those with two or more internal and external hemorrhoids or hemorrhoid groups that require excision. The procedure is typically performed on patients who have not responded to conservative treatment methods. The provider must ensure that the patient is appropriately prepped and anesthetized before proceeding with the excision.

5. When to use CPT code 46260

CPT code 46260 should be used when the provider performs the excision of two or more internal and external hemorrhoids or hemorrhoid groups. It is important to note that this code should not be used for less extensive or complex hemorrhoidectomies.

6. Documentation requirements

To support a claim for CPT 46260, the provider must document the following information:

• Patient’s diagnosis and the need for hemorrhoidectomy
• Details of the procedure, including the number of hemorrhoids or hemorrhoid groups excised
• Any complications or additional procedures performed
• Post-operative care instructions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 46260, ensure that the procedure meets the criteria for excising two or more internal and external hemorrhoids or hemorrhoid groups. It is important to follow the specific documentation requirements and guidelines set forth by the payer. Additionally, be aware of any bundling or unbundling issues that may affect the billing of this code.

8. Historical information

CPT 46260 was added to the Current Procedural Terminology system on January 1, 1990. On January 1, 2010, the code description was changed to include complex or extensive hemorrhoidectomies.

9. Examples

1. A provider performs a hemorrhoidectomy on a patient with three internal and two external hemorrhoids.
2. A patient undergoes a hemorrhoidectomy for the excision of four internal and three external hemorrhoids.
3. A provider performs a hemorrhoidectomy on a patient with two internal and two external hemorrhoid groups.
4. A patient undergoes a hemorrhoidectomy for the excision of three internal and four external hemorrhoid groups.
5. A provider performs a hemorrhoidectomy on a patient with two internal and three external hemorrhoids.
6. A patient undergoes a hemorrhoidectomy for the excision of five internal and two external hemorrhoids.
7. A provider performs a hemorrhoidectomy on a patient with three internal and four external hemorrhoids.
8. A patient undergoes a hemorrhoidectomy for the excision of two internal and three external hemorrhoid groups.
9. A provider performs a hemorrhoidectomy on a patient with four internal and two external hemorrhoid groups.
10. A patient undergoes a hemorrhoidectomy for the excision of three internal and five external hemorrhoid groups.