How To Use CPT Code 46262

CPT 46262 describes the excision of two or more columns or groups of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary. 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 46262?

CPT 46262 can be used to describe the excision of two or more columns or groups of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary. This code is used when the provider removes these structures during a surgical procedure.

2. Official Description

The official description of CPT code 46262 is: ‘Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed.’

3. Procedure

1. The provider begins by preparing the patient and administering anesthesia.
2. Once the patient is ready, the provider locates the groups of external hemorrhoids near the anal canal and internal hemorrhoids inside the anus.
3. Using appropriate instruments, the provider makes incisions around the hemorrhoid columns and separates the hemorrhoids from surrounding tissues.
4. The provider then removes the hemorrhoids through the anal canal.
5. If a fistula is present, the provider incises around it and removes the diseased area.
6. If a fissure is present, the provider may also remove it by incising around it.
7. The operative sites are irrigated with antibiotics to prevent infection.
8. Finally, the provider closes the incisions with sutures or leaves the wounds open for self-healing.

4. Qualifying circumstances

Patients eligible for CPT 46262 are those with internal and external hemorrhoids requiring excision, along with a fistulectomy and fissurectomy if necessary. The procedure is performed by a qualified provider who has the necessary skills and training to perform the surgery. The patient must have a documented diagnosis of hemorrhoids and may have accompanying symptoms such as bleeding, pain, or discomfort.

5. When to use CPT code 46262

CPT code 46262 should be used when a provider performs the excision of two or more columns or groups of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary. This code is appropriate when the procedure is performed as a standalone surgery.

6. Documentation requirements

To support a claim for CPT 46262, the provider must document the following information:

• Patient’s diagnosis of hemorrhoids
• Details of the excision procedure, including the number of columns or groups of hemorrhoids removed
• Description of the fistulectomy and fissurectomy, if performed
• Operative notes, including any complications or unexpected findings
• Post-operative care instructions
• Signature of the provider performing the surgery

7. Billing guidelines

When billing for CPT 46262, ensure that the excision of two or more columns or groups of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if performed, is documented. It is important to follow the guidelines set by the payer and use the appropriate modifiers if necessary. Do not report CPT 46262 in conjunction with CPT 46948.

8. Historical information

CPT 46262 was added to the Current Procedural Terminology system on January 1, 1990. On January 1, 2010, the code was changed to include complex or extensive hemorrhoidectomy with fistulectomy, with or without fissurectomy.

9. Examples

1. A surgeon performing the excision of two or more columns of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with severe hemorrhoidal disease.
2. A gastroenterologist performing the excision of multiple groups of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with recurrent hemorrhoids.
3. A colorectal surgeon performing the excision of extensive internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with chronic hemorrhoidal symptoms.
4. A general surgeon performing the excision of two columns of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with hemorrhoidal bleeding.
5. An colorectal specialist performing the excision of multiple groups of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with hemorrhoidal pain and discomfort.
6. A proctologist performing the excision of two or more columns of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with hemorrhoidal prolapse.
7. A surgeon performing the excision of extensive internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with hemorrhoidal thrombosis.
8. A gastroenterologist performing the excision of multiple groups of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with hemorrhoidal itching and irritation.
9. A colorectal surgeon performing the excision of two columns of internal and external hemorrhoids, along with a fistulectomy and fissurectomy if necessary, for a patient with hemorrhoidal skin tags.