How To Use CPT Code 46948

CPT 46948 describes a specific procedure for the treatment of hemorrhoids using minimally invasive techniques. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 46948?

CPT 46948 is a code that represents a surgical procedure used to treat hemorrhoids. It involves cutting off the blood supply to two or more hemorrhoid columns or groups using ultrasound guidance. Additionally, the provider may perform a mucopexy, which involves repairing prolapsing mucosa by plicating it.

2. Official Description

The official description of CPT code 46948 is: ‘Hemorrhoidectomy, internal, by transanal hemorrhoidal dearterialization, 2 or more hemorrhoid columns/groups, including ultrasound guidance, with mucopexy, when performed.’

3. Procedure

1. The provider begins by inserting a proctoscope fitted with a Doppler probe and a light source into the anus and up to the lower rectum.
2. Using the Doppler probe, the provider identifies the hemorrhoidal arteries supplying the hemorrhoid columns or groups.
3. Once the artery has been identified, the provider ligates it with absorbable sutures.
4. If there is hemorrhoidal prolapse, the provider performs endorectal plication of the excess and/or prolapsing mucosa and submucosa.
5. The provider sutures the prolapsing mucosa with a continuous running suture in a proximal to distal direction.
6. After completing the procedure, the proctoscope is removed.

4. Qualifying circumstances

CPT 46948 is used for patients who require treatment for hemorrhoids involving two or more hemorrhoid columns or groups. The procedure must be performed by a qualified healthcare provider and include ultrasound guidance. It is important to note that CPT 46948 should not be reported in conjunction with codes 76872, 76942, or 76998. For transanal hemorrhoidal dearterialization of a single hemorrhoid column or group, use code 46999.

5. When to use CPT code 46948

CPT code 46948 should be used when a provider performs a hemorrhoidectomy using transanal hemorrhoidal dearterialization on two or more hemorrhoid columns or groups. It is important to ensure that the procedure includes ultrasound guidance and mucopexy. This code should not be used in conjunction with codes 76872, 76942, or 76998.

6. Documentation requirements

To support a claim for CPT 46948, the provider must document the following information:

• Patient’s diagnosis and the need for hemorrhoidectomy
• Details of the procedure performed, including the use of ultrasound guidance and mucopexy
• Date of the procedure
• Any additional relevant information or complications
• Signature of the performing healthcare provider

7. Billing guidelines

When billing for CPT 46948, ensure that the procedure meets the specific criteria outlined in the code description. It is important to note that CPT 46948 should not be reported in conjunction with codes 76872, 76942, or 76998. It is also recommended to review additional tips and guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 46948 was added to the Current Procedural Terminology system on January 1, 2020. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a hemorrhoidectomy using transanal hemorrhoidal dearterialization for the treatment of multiple hemorrhoid columns.
2. A provider performs a hemorrhoidectomy using transanal hemorrhoidal dearterialization with mucopexy on two hemorrhoid groups.
3. A patient with prolapsing hemorrhoids undergoes a hemorrhoidectomy using transanal hemorrhoidal dearterialization and mucopexy.
4. A provider performs a hemorrhoidectomy using transanal hemorrhoidal dearterialization on three hemorrhoid columns.
5. A patient undergoes a hemorrhoidectomy using transanal hemorrhoidal dearterialization with mucopexy for the treatment of four hemorrhoid groups.
6. A provider performs a hemorrhoidectomy using transanal hemorrhoidal dearterialization on two hemorrhoid columns and performs mucopexy to repair prolapsing mucosa.
7. A patient with hemorrhoids undergoes a hemorrhoidectomy using transanal hemorrhoidal dearterialization and mucopexy for the treatment of multiple hemorrhoid groups.
8. A provider performs a hemorrhoidectomy using transanal hemorrhoidal dearterialization on three hemorrhoid columns and performs mucopexy to repair prolapsing mucosa.
9. A patient undergoes a hemorrhoidectomy using transanal hemorrhoidal dearterialization with mucopexy for the treatment of two hemorrhoid groups.
10. A provider performs a hemorrhoidectomy using transanal hemorrhoidal dearterialization on four hemorrhoid columns and performs mucopexy to repair prolapsing mucosa.