tci General Surgery Coding Alert - 2008 Issue 2

Reader Question: Internal Excision = 'Any Method'

Question: What code is appropriate if the surgeon removes internal hemorrhoids by excision? CPT lists codes for excision of external and "external and internal" hemorrhoids, but nothing for internal only. Should I report the "external and internal" code with a modifier 52? Florida Subscriber Answer: A parenthetical note following "destruction of hemorrhoid" codes 46934-46936 directs you to 46250-46262 for hemorrhoid excision. As you note, however, none of the codes in the 46250-46262 range specifically apply to internal hemorrhoids, and refer instead to external or "internal and external" hemorrhoids. Although you might be tempted to append modifier 52 (Reduced services)...

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