2025 CPT code 46221
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Hemorrhoidectomy, internal, by rubber band ligation(s).
Modifiers may be applicable depending on circumstances (e.g., multiple procedures, reduced services).
Medical necessity for 46221 is established by the presence of symptomatic internal hemorrhoids that have not responded to conservative treatment.
The physician identifies the internal hemorrhoid using an anoscope, mobilizes it to expose the base, and then applies the rubber band ligature. This is usually an in office procedure and can be performed without sedation or bowel prep. The number of rubber bands may be limited if done in office.
In simple words: Rubber band ligation is a procedure used to treat internal hemorrhoids. A doctor inserts a small viewing tube into the anus and places a rubber band around the base of the hemorrhoid. This cuts off the blood flow, causing it to shrink and fall off within about a week.
This procedure involves ligating the base of internal hemorrhoids with rubber bands.The provider, after prepping and anesthetizing the patient, visualizes the hemorrhoid with an anoscope, grasps it with forceps, and places a rubber band around its base using a ligator device. This cuts off the blood supply, causing the hemorrhoid to shrink, die, and eventually fall off within a week.A scar forms at the site, preventing other veins from bulging into the anal canal.
Example 1: A patient presents with grade 2 internal hemorrhoids causing bleeding and discomfort. Rubber band ligation is performed in the office., A patient has multiple grade 1 internal hemorrhoids. Several sessions of rubber band ligation are scheduled to address each hemorrhoid., A patient with a prolapsing internal hemorrhoid undergoes rubber band ligation to reduce prolapse and alleviate symptoms.
Documentation should include the number and grade of hemorrhoids treated, the location (internal), the method used (rubber band ligation), any complications, and post-procedure instructions.
- Revenue Code: P6C - MINOR PROCEDURES - OTHER (MEDICARE FEE SCHEDULE)
- Specialties:General surgery, colorectal surgery, gastroenterology.
- Place of Service:Office