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The procedure described by CPT® Code 46930 involves the destruction of internal hemorrhoids through the application of thermal energy. Internal hemorrhoids are abnormal, sac-like protrusions formed by swollen blood vessels located within the rectum. These hemorrhoids can sometimes protrude through the anus, a condition known as prolapse, and may become thrombosed, leading to significant discomfort and complications. The procedure begins with the gentle dilation of the anal canal, which is typically achieved by the insertion of one or two gloved fingers. This allows for better access to the hemorrhoid. Once the hemorrhoid is identified, it is grasped using forceps, and traction is applied to draw it out of the anal canal for treatment. The thermal energy is then applied to the tissue located just proximal to the hemorrhoid. There are three primary methods of delivering this thermal energy: infrared coagulation, which utilizes infrared light; cautery, which employs an electrocautery probe; and radiofrequency, which uses an electrode. Each of these methods generates a thermal lesion, or burn, in the targeted tissue, effectively disrupting the blood supply to the hemorrhoid. This disruption leads to the shrinkage of the hemorrhoid, alleviating the symptoms associated with this condition.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 46930 is indicated for the treatment of internal hemorrhoids that may cause significant discomfort or complications. The following conditions are explicitly recognized as indications for this procedure:
The procedure for the destruction of internal hemorrhoids by thermal energy involves several key steps, each critical to the successful treatment of the condition. The following procedural steps are outlined:
Following the destruction of internal hemorrhoids by thermal energy, patients can expect a recovery period that may vary based on individual circumstances. Post-procedure care typically includes monitoring for any signs of complications, such as excessive bleeding or infection. Patients are often advised to avoid strenuous activities and heavy lifting for a specified period to promote healing. Pain management may be necessary, and over-the-counter analgesics are commonly recommended. Additionally, patients should be instructed on maintaining a high-fiber diet and adequate hydration to prevent constipation, which can exacerbate hemorrhoid symptoms. Follow-up appointments may be scheduled to assess the healing process and ensure that the treatment has been effective.
| Short Descr | DESTROY INTERNAL HEMORRHOIDS | Medium Descr | DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY | Long Descr | Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency) | 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) | 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 | Procedure or Service, Multiple Reduction Applies | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - 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.) | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AG | Primary physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | LT | Left side (used to identify procedures performed on the left side of the body) | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure | SG | Ambulatory surgical center (asc) facility service | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2009-01-01 | Added | - |
| 1985-12-31 | Deleted | Code deleted. |
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