How To Use CPT Code 46946

CPT 46946 describes a specific procedure for the removal of two or more hemorrhoid columns or groups using ligation techniques other than the rubber band method. This article will provide an overview of CPT code 46946, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 46946?

CPT 46946 is a code used to describe a procedure that involves the removal of two or more hemorrhoid columns or groups using ligation techniques other than the rubber band method. This code is specifically used when the provider performs the procedure using alternative techniques such as transfixion suture excision, sclerotherapy, or infrared coagulation.

2. Official Description

The official description of CPT code 46946 is: ‘Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance.’ It is important to note that this code should not be reported in conjunction with codes 46221, 46945, or 46948.

3. Procedure

1. The provider performs a procedure to remove two or more hemorrhoid columns or groups using ligation techniques other than the rubber band method.

There are several techniques that the provider may use, including:

• Transfixion suture excision: The provider places a crisscross stitch and then ligates, or ties, the suture off to control bleeding from a hemorrhoid.
• Sclerotherapy: The provider injects a medicine into the vessels to shrink the blood vessels.
• Infrared coagulation: The provider applies an infrared coagulator, which uses heat from an intense beam of infrared light, to induce coagulation of internal hemorrhoids.

4. Qualifying circumstances

CPT code 46946 is used when the provider performs the procedure to remove two or more hemorrhoid columns or groups using ligation techniques other than the rubber band method. It is important to note that this code should not be reported in conjunction with codes 46221, 46945, or 46948.

5. When to use CPT code 46946

CPT code 46946 should be used when the provider performs the specific procedure of removing two or more hemorrhoid columns or groups using ligation techniques other than the rubber band method. It is important to ensure that the procedure meets the criteria outlined in the official description of the code.

6. Documentation requirements

To support a claim for CPT code 46946, the provider must document the following information:

• Specific details of the procedure performed, including the number of hemorrhoid columns or groups removed and the ligation technique used
• Date of the procedure
• Any additional relevant information, such as the patient’s condition or any complications encountered

7. Billing guidelines

When billing for CPT code 46946, it is important to ensure that the procedure meets the criteria outlined in the official description. This code should not be reported in conjunction with codes 46221, 46945, or 46948. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT code 46946 was added to the Current Procedural Terminology system on January 1, 1990. There have been historical changes to the code, including updates on January 1, 2010, and January 1, 2020. These changes reflect modifications to the description and coding guidelines for the procedure.

9. Examples

1. A provider performs a procedure to remove three hemorrhoid columns using transfixion suture excision.
2. Using sclerotherapy, a provider removes two hemorrhoid groups in a patient.
3. A provider performs infrared coagulation to remove four hemorrhoid columns in a patient.
4. During a procedure, a provider removes three hemorrhoid groups using a combination of transfixion suture excision and sclerotherapy.
5. A patient undergoes a procedure in which five hemorrhoid columns are removed using infrared coagulation.