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Hemorrhoids are swollen blood vessels located in the anal region, which can be classified into two types: internal and external. Internal hemorrhoids are situated within the anal canal, while external hemorrhoids are found outside the anal opening. The procedure described by CPT® Code 46257 involves a hemorrhoidectomy that addresses both internal and external hemorrhoids, specifically focusing on a single column or group of these enlarged vessels. During the hemorrhoidectomy, the physician performs an elliptical incision around the hemorrhoidal mass, excising it completely down to the muscle tissue. This excision is crucial for alleviating the symptoms associated with hemorrhoids, such as pain, bleeding, and discomfort. In addition to the hemorrhoidectomy, this procedure includes a fissurectomy, which is the surgical removal of anal fissures—painful tears in the mucous membrane of the anus. The fissurectomy is performed by making an incision adjacent to the fissure and excising it entirely. This combined approach of treating both hemorrhoids and fissures aims to provide comprehensive relief from anal discomfort and improve the patient's quality of life. The procedure is typically performed under anesthesia, and careful attention is given to controlling any bleeding that may occur during the excision process. Overall, CPT® Code 46257 represents a significant surgical intervention for patients suffering from both hemorrhoids and anal fissures, addressing their conditions in a single operative session.
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The procedure described by CPT® Code 46257 is indicated for patients experiencing the following conditions:
The procedure for CPT® Code 46257 involves several key steps that are performed to effectively treat both hemorrhoids and anal fissures:
After the completion of the procedure, patients are typically monitored for any immediate complications. Post-procedure care may include pain management, instructions for wound care, and recommendations for dietary modifications to prevent constipation and promote bowel regularity. Patients are advised to follow up with their healthcare provider to ensure proper healing and to address any concerns that may arise during the recovery period. It is important for patients to adhere to the post-operative instructions provided by their surgeon to facilitate optimal recovery and minimize the risk of complications.
| Short Descr | REMOVE IN/EX HEM GRP & FISS | Medium Descr | HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO | Long Descr | Hemorrhoidectomy, internal and external, single column/group; with fissurectomy | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 1 - Statutory 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 | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 81 - Hemorrhoid procedures |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 74 | Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53. | GC | This service has been performed in part by a resident under the direction of a teaching physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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