How To Use CPT Code 46320

CPT 46320 describes the excision of a thrombosed hemorrhoid, which is a swollen vein or group of veins containing blood, located in the anal canal distal to the dentate line. 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 46320?

CPT 46320 is used to describe the excision of a thrombosed hemorrhoid, which is a swollen vein or group of veins containing blood, located in the anal canal distal to the dentate line. This procedure involves the removal of the skin over the thrombosed hemorrhoids and the excision of the underlying thrombosis. The provider may choose to close the excised area with sutures or leave it open for drainage.

2. Official Description

The official description of CPT code 46320 is: ‘Excision of thrombosed hemorrhoid, external.’

3. Procedure

1. The provider preps and anesthetizes the patient appropriately.
2. An elliptical incision is made over the thrombosed hemorrhoids.
3. The provider uses scissors to remove the skin and excise the underlying thrombosis.
4. The area is allowed to drain, and bleeding is controlled.
5. The provider may choose to close the excised area with sutures or leave it open for drainage.

4. Qualifying circumstances

CPT 46320 is performed on patients with a thrombosed hemorrhoid, which is a swollen vein or group of veins containing blood, located in the anal canal distal to the dentate line. The procedure is typically performed by a qualified healthcare professional who has determined that excision is necessary for the patient’s condition.

5. When to use CPT code 46320

CPT code 46320 should be used when a provider performs the excision of a thrombosed hemorrhoid. It is important to note that this code specifically applies to external thrombosed hemorrhoids. If the thrombosed hemorrhoid is internal, a different code should be used.

6. Documentation requirements

To support a claim for CPT 46320, the provider must document the following information:

• Patient’s diagnosis of a thrombosed hemorrhoid
• Details of the procedure, including the incision, removal of the skin, and excision of the thrombosis
• Method of closure, whether sutures or leaving the area open for drainage
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 46320, ensure that the procedure performed is the excision of a thrombosed hemorrhoid. It is important to use the appropriate code for external thrombosed hemorrhoids and not for internal ones. Additionally, follow any specific guidelines provided by the payer regarding documentation and coding for this procedure.

8. Historical information

CPT 46320 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs the excision of a thrombosed hemorrhoid for a patient with severe pain and swelling in the anal area.
2. A patient presents with a thrombosed hemorrhoid that is causing discomfort and bleeding. The provider decides to perform an excision to alleviate the symptoms.
3. A provider performs the excision of a thrombosed hemorrhoid for a patient who has failed conservative treatment options.
4. A patient with a thrombosed hemorrhoid seeks medical attention, and the provider determines that an excision is necessary to relieve the patient’s symptoms.
5. A provider performs the excision of a thrombosed hemorrhoid for a patient who has a history of recurrent hemorrhoids and is experiencing severe pain.
6. A patient presents with a thrombosed hemorrhoid that is causing significant discomfort and difficulty with daily activities. The provider decides to perform an excision to improve the patient’s quality of life.
7. A provider performs the excision of a thrombosed hemorrhoid for a patient who has tried conservative management options without success.
8. A patient with a thrombosed hemorrhoid seeks medical attention due to persistent pain and swelling. The provider determines that an excision is necessary to provide relief.
9. A provider performs the excision of a thrombosed hemorrhoid for a patient who has a history of recurrent thrombosed hemorrhoids and is experiencing severe symptoms.
10. A patient presents with a thrombosed hemorrhoid that is causing significant discomfort and affecting their daily activities. The provider decides to perform an excision to improve the patient’s overall well-being.