How To Use CPT Code 46945

CPT 46945 describes the procedure of internal hemorrhoidectomy using ligation other than rubber band, specifically for a single hemorrhoid column or group, without the use of imaging guidance. This article will provide an overview of CPT code 46945, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 46945?

CPT 46945 is used to report the surgical removal of a single hemorrhoid or a group of hemorrhoids using ligation techniques other than the rubber band method. This procedure is performed by a healthcare provider to address swollen blood vessels in the rectum or anus, known as hemorrhoids. It is important to note that this code should only be used when the procedure is performed without the guidance of imaging techniques.

2. Official Description

The official description of CPT code 46945 is: ‘Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance.’

3. Procedure

1. During the procedure, the healthcare provider utilizes various techniques, excluding the rubber band method, to remove a single hemorrhoid or a group of hemorrhoids.
2. One technique involves the placement of a crisscross stitch, followed by the ligation or tying off of the suture to control bleeding from the hemorrhoid. This technique is commonly referred to as transfixion suture excision.
3. Another technique is the use of sclerotherapy, where the provider injects a medicine into the blood vessels to shrink them.
4. Infrared coagulation is another method employed, where the provider applies an infrared coagulator that uses heat from an intense beam of infrared light to induce coagulation and shrink the internal hemorrhoid.

4. Qualifying circumstances

CPT code 46945 is applicable when a healthcare provider performs an internal hemorrhoidectomy using ligation techniques other than the rubber band method. This procedure is specifically intended for the removal of a single hemorrhoid column or group. It is important to note that the procedure should be performed without the use of imaging guidance.

5. When to use CPT code 46945

CPT code 46945 should be used when a healthcare provider performs an internal hemorrhoidectomy using ligation techniques other than the rubber band method. It is important to ensure that the procedure is performed for a single hemorrhoid column or group and without the use of imaging guidance. If the provider removes two or more hemorrhoid groups, CPT code 46946 should be reported instead.

6. Documentation requirements

To support a claim for CPT code 46945, the healthcare provider must document the following information:

• The diagnosis indicating the need for the internal hemorrhoidectomy
• The specific ligation technique used for the procedure
• The date of the procedure
• Any additional details regarding the procedure, such as the number of hemorrhoids removed
• The signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 46945, it is crucial to ensure that the procedure meets the specific criteria outlined in the code description. The procedure should involve the removal of a single hemorrhoid column or group using ligation techniques other than the rubber band method. It is important to note that CPT code 46945 should not be reported if other codes, such as CPT codes 46966 to 46968, have already been performed within the previous seven days. Additionally, it is essential to consider the location of the testing when coding for hemorrhoidectomy procedures.

8. Historical information

CPT code 46945 has undergone several changes throughout its history. On January 1, 1990, the code was added to the Current Procedural Terminology system. It was then modified on January 1, 2010, to its current description of ‘Ligation of internal hemorrhoids; single procedure.’ The most recent change occurred on January 1, 2020, when the code description was updated to ‘Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group.’

9. Examples

1. A healthcare provider performs an internal hemorrhoidectomy using ligation techniques other than the rubber band method to remove a single hemorrhoid column in a patient.
2. During the procedure, the healthcare provider utilizes a transfixion suture excision technique to remove a group of hemorrhoids without the use of imaging guidance.
3. A patient undergoes an internal hemorrhoidectomy, and the healthcare provider employs sclerotherapy to shrink the blood vessels of a single hemorrhoid column.
4. A healthcare provider performs an internal hemorrhoidectomy using infrared coagulation to induce coagulation and shrink a group of hemorrhoids.
5. During the procedure, the healthcare provider removes a single hemorrhoid column using ligation techniques other than the rubber band method.
6. A patient undergoes an internal hemorrhoidectomy, and the healthcare provider utilizes a transfixion suture excision technique to remove a group of hemorrhoids without the use of imaging guidance.
7. A healthcare provider performs an internal hemorrhoidectomy using sclerotherapy to shrink the blood vessels of a single hemorrhoid column.
8. During the procedure, the healthcare provider employs infrared coagulation to induce coagulation and shrink a group of hemorrhoids.
9. A patient undergoes an internal hemorrhoidectomy, and the healthcare provider removes a single hemorrhoid column using ligation techniques other than the rubber band method.
10. During the procedure, the healthcare provider utilizes a transfixion suture excision technique to remove a group of hemorrhoids without the use of imaging guidance.