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Hemorrhoids are enlarged blood vessels, also known as varices, located in the anal region. They can be classified into two main types: internal hemorrhoids, which are situated inside the anal canal, and external hemorrhoids, which are found outside the anal opening. The procedure described by CPT® Code 46261 involves a hemorrhoidectomy that addresses both internal and external hemorrhoids, specifically when there are two or more columns or groups of hemorrhoids present. In addition to the excision of these hemorrhoids, this procedure includes a fissurectomy, which is the surgical removal of anal fissures—painful cracks in the mucous membrane of the anus. The technique for performing the hemorrhoidectomy involves making an elliptical incision around the hemorrhoidal mass, followed by dissection down to the muscle tissue to completely excise the hemorrhoids. Bleeding during the procedure is typically controlled using electrocautery, and the surgical site may be closed with sutures or left open to heal naturally. The fissurectomy is performed by making an incision adjacent to the fissure, which is then excised in its entirety. This comprehensive approach addresses both the hemorrhoids and any associated fissures, providing relief from pain and discomfort associated with these conditions.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 46261 is indicated for patients experiencing significant discomfort or complications due to the presence of both internal and external hemorrhoids, particularly when there are two or more columns or groups involved. Additionally, it is performed in cases where anal fissures are present, which can cause severe pain and discomfort during bowel movements. The combination of hemorrhoidectomy and fissurectomy aims to alleviate symptoms and improve the patient's quality of life.
The procedure for CPT® Code 46261 involves several key steps to ensure the effective removal of hemorrhoids and the associated fissure.
After the completion of the procedure, patients are typically monitored for any immediate complications. Post-operative care may include pain management strategies, instructions for wound care, and recommendations for dietary modifications to promote healing and prevent constipation. Patients are advised to follow up with their healthcare provider to assess recovery and address any concerns that may arise during the healing process. It is important for patients to adhere to the post-operative instructions to ensure optimal recovery and minimize the risk of complications.
| Short Descr | REMOVE IN/EX HEM GRPS & FISS | Medium Descr | HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU | Long Descr | Hemorrhoidectomy, internal and external, 2 or more columns/groups; 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 |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service |
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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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