2025 CPT code 46500
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Injection of a sclerosing solution into hemorrhoids to reduce blood flow and shrink their size.
Modifiers may be applied as clinically appropriate, such as modifier 51 (multiple procedures) if multiple hemorrhoids are treated in a single session. Refer to the AMA CPT manual for specific guidance.
Medical necessity is established by the presence of symptomatic hemorrhoids unresponsive to conservative management, affecting the patient's quality of life.
The physician identifies and injects the hemorrhoids with the sclerosing solution. Post-procedure care instructions are provided.
In simple words: This treatment involves injecting a special solution near hemorrhoids to reduce blood flow and make them shrink. It's a minor procedure, usually done in a doctor's office, with little to no pain.
Sclerotherapy for hemorrhoids involves injecting a sclerosing solution (e.g., phenol in almond oil, 50% dextrose water, zinc chloride, quinine, or polidocanol) into the submucosa beneath the hemorrhoid. This reduces blood flow to the hemorrhoid, causing it to shrink over time. The procedure is typically performed using a proctoscope to visualize the hemorrhoids and is usually an outpatient procedure with minimal discomfort. Multiple sessions may be necessary for complete hemorrhoid reduction.
Example 1: A 35-year-old female presents with bleeding and discomfort from grade 1 internal hemorrhoids.Sclerotherapy is performed. , A 50-year-old male experiences recurrent bleeding from grade 2 internal hemorrhoids despite lifestyle modifications. Multiple sclerotherapy sessions are scheduled over several weeks. , A 62-year-old patient with multiple small internal hemorrhoids opts for sclerotherapy as a minimally invasive alternative to surgical intervention.
Patient history, physical examination documenting hemorrhoids, procedure note detailing the type and amount of sclerosant injected, and post-procedure instructions.
** Sclerotherapy is generally considered a safe and minimally invasive procedure. However, potential complications include pain, bleeding, and infection.Patient selection is crucial, typically reserved for smaller, internal hemorrhoids (grades 1-2).
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- RVU: Refer to the CMS fee schedule for current RVU values and reimbursement rates.
- Global Days: Not applicable; this is a single procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Refer to the CMS fee schedule for historical fee data.
- Specialties:Proctology, Gastroenterology, General Surgery
- Place of Service:Office, Outpatient Surgery Center