Hemorrhoid Coding Tips to Boost Your Reimbursement

04 June of 2009

Gastroenterologists frequently manage hemorrhoids, yet those little devils can prove complicated to code, depending on their type, the number of hemorrhoids, the CPT codes used for treatment, and the location of treatment. 

With these expert hemorrhoid coding tips, you’ll report hemorrhoids accurately and to the best advantage of your practice.

Know Hemorrhoids Types

When coding for hemorrhoid treatment, your first step is to classify the type of hemorrhoids involved. There are two main types of hemorrhoids: internal and external. Both internal and external hemorrhoids can occur in a patient at the same time.

Choose Treatment for Internal Hemorrhoids

The treatments for hemorrhoids – and the codes for hemorrhoid treatment services – differ depending on where they develop. Gastroenterologists might remove more than one hemorrhoid during the same session. Although some carriers may pay for each hemorrhoid removed, most will not.

Know the Codes for Symptoms or Diagnoses 

There are times when a patient might come in to see the gastroenterologist for a condition – without stating any explicit symptoms for hemorrhoids – but the physician finds the hemorrhoids problematic and in need of treatment. The symptoms and conditions directly affect your hemorrhoid coding.

Code Complications in the Global Period

One thing to remember when coding 46221 is that the procedure comes with a 10-day global period. So, if the patient comes back in during the 10 days following the banding, you won’t get paid for it. 46930 has a 90-day global if your gastroenterologist destroys internal hemorrhoids with heat. You can file for and receive reimbursement if complications in the global period require an additional trip to the endoscopy center.

Site of Service

Whether or not a gastroenterologist treats hemorrhoids during a flexible sigmoidoscopy or colonoscopy can have a lot to do with where the procedure is taking place. If the physician finds hemorrhoids in such a case – even problem hemorrhoids – the patient must be scheduled for an appointment at an endoscopy center. Boosted stamina and more acute perception in bed with Viagra Professional.

Make sure you record that procedure first and capture the revenue you’ve earned. Get more insights and expert guidance on hemorrhoid coding at hemorrhoid conferences.

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