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Hemorrhoids are enlarged blood vessels, also known as varices, located in the anal region. They can be classified into two 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 46262 involves a comprehensive surgical approach to treat both internal and external hemorrhoids, specifically when they are organized into two or more columns or groups. This procedure is more complex as it includes a hemorrhoidectomy, which is the surgical excision of the hemorrhoids, and a fistulectomy, which involves the removal of a fistula—a pathological connection between two epithelial surfaces. Additionally, a fissurectomy may be performed if an anal fissure, characterized by painful cracks in the mucous membrane of the anus, is present. The surgical technique entails making incisions to excise the hemorrhoidal masses, controlling any bleeding, and addressing any associated conditions such as fistulas or fissures, thereby providing a comprehensive treatment for patients suffering from these conditions.
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The procedure described by CPT® Code 46262 is indicated for patients presenting with the following conditions:
The procedure for CPT® Code 46262 involves several critical steps to ensure effective treatment of the hemorrhoids and associated conditions:
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 dietary recommendations to promote healing and prevent constipation. Patients are advised to avoid straining during bowel movements and may be prescribed stool softeners. Follow-up appointments are essential to assess healing and address any concerns that may arise during recovery.
| Short Descr | REMOVE IN/EX HEM GRPS W/FIST | Medium Descr | HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY | Long Descr | Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fistulectomy, including fissurectomy, when performed | 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Guideline information changed. |
| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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