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CPT®
0249T

CPT® Code 0249T
Deleted

Code deleted, see 46948

Official Description

Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 0249T involves the ligation of hemorrhoidal vascular bundles, which are groups of blood vessels that can become enlarged and protrude into the anal canal, resulting in a condition known as hemorrhoids. These vascular beds consist of connective tissue, smooth muscle, and blood vessels that surround the anal canal. When these structures become engorged, they can lead to discomfort, pain, and other symptoms associated with hemorrhoids. The ligation procedure aims to address this condition by cutting off the blood supply to the affected vascular bundle. This is achieved through the use of ultrasound guidance, which allows the physician to accurately locate the involved vascular bundle. Once identified, the vascular bundle is grasped with forceps, and a suture ligature is applied to occlude the blood flow. Following the ligation, any tissue distal to the ligature is excised, effectively removing the problematic hemorrhoidal tissue. This procedure is typically performed to alleviate the symptoms associated with hemorrhoids and improve the patient's quality of life.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The ligation of hemorrhoidal vascular bundles is indicated for patients experiencing symptoms related to hemorrhoids. These symptoms may include:

  • Hemorrhoidal Prolapse The protrusion of hemorrhoids into the anal canal, which can cause discomfort and pain.
  • Bleeding Rectal bleeding associated with hemorrhoids, which may occur during bowel movements.
  • Itching or Irritation Persistent itching or irritation around the anal area due to swollen hemorrhoids.
  • Pain Discomfort or pain in the anal region, particularly during bowel movements or sitting.

2. Procedure

The procedure for ligation of hemorrhoidal vascular bundles involves several key steps, which are detailed as follows:

  • Step 1: Preparation The patient is positioned appropriately, and the anal area is prepared for the procedure. This may include cleansing the area and administering local anesthesia to minimize discomfort during the procedure.
  • Step 2: Ultrasound Guidance Using ultrasound technology, the physician locates the specific hemorrhoidal vascular bundle that requires ligation. This imaging technique provides real-time visualization, ensuring accurate identification of the target area.
  • Step 3: Grasping the Vascular Bundle Once the vascular bundle is located, the physician uses forceps to grasp the entire bundle securely. This step is crucial for ensuring that the ligation is effective and that the correct tissue is targeted.
  • Step 4: Ligation The physician then applies a suture ligature around the grasped vascular bundle. This ligation cuts off the blood supply to the hemorrhoid, leading to its eventual shrinkage and resolution of symptoms.
  • Step 5: Tissue Excision After ligation, any tissue distal to the ligature is excised. This step helps to remove any remaining problematic tissue and further alleviates symptoms associated with the hemorrhoids.

3. Post-Procedure

Following the ligation procedure, patients may experience some discomfort or pain in the anal area, which is typically manageable with over-the-counter pain relief medications. It is important for patients to follow post-procedure care instructions provided by their healthcare provider, which may include recommendations for dietary modifications, such as increasing fiber intake to promote regular bowel movements and prevent straining. Patients should also be advised to monitor for any signs of complications, such as excessive bleeding or infection, and to follow up with their healthcare provider as needed. Recovery time may vary, but many patients can return to normal activities within a few days, depending on their individual circumstances and the extent of the procedure performed.
Short Descr LIGATION HEMORRHOID W/US
Medium Descr LIGATION HEMORRHOID BUNDLE W/US
Long Descr Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance
Status Code Carriers Price the Code
Global Days YYY - Carrier Determines Whether Global Concept Applies
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE Not applicable/unspecified.
CCS Clinical Classification 81 - Hemorrhoid procedures
Date
Action
Notes
2019-12-31 Deleted Code deleted, see 46948
2011-01-01 Added Added
Code
Description
Code
Description
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