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2025 CPT code 46320

Excision of a thrombosed external hemorrhoid.

Refer to the current CPT guidelines for coding hemorrhoid procedures.

Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual for specific modifier guidance.

Medical necessity for excision is established by the presence of a painful, thrombosed external hemorrhoid, typically within 72 hours of onset of symptoms.The procedure is considered medically necessary to relieve acute pain and prevent complications such as infection or further thrombosis.However, the procedure may still be considered if the patient presents beyond the 72 hour window and the pain is significant.

The physician is responsible for performing the surgical excision, ensuring proper anesthesia and hemostasis, and managing any potential complications.Post-operative care instructions are also provided.

IMPORTANT:For incision of a thrombosed external hemorrhoid, use 46083.For ligation of internal hemorrhoids, see 46221, 46945, 46946. For excision of internal and/or external hemorrhoids, see 46250-46262. For injection of hemorrhoids, use 46500. For destruction of internal hemorrhoids by thermal energy, use 46930. For destruction of hemorrhoids by cryosurgery, use 46999. For transanal hemorrhoidal dearterialization, including ultrasound guidance, with mucopexy, when performed, use 46948. For hemorrhoidopexy, use 46947.

In simple words: The doctor cuts out a swollen, clotted vein (hemorrhoid) near the anus.This relieves pain and prevents further clotting.

This procedure involves the surgical removal of a thrombosed external hemorrhoid.An elliptical incision is made over the hemorrhoid, and the clot and surrounding diseased tissue are excised.The area may be left open to drain or closed with sutures.Hemostasis is carefully maintained throughout the procedure. The dentate line is the anatomical boundary distinguishing external from internal hemorrhoids.

Example 1: A 35-year-old male presents with an acutely painful, thrombosed external hemorrhoid that developed 2 days prior. The physician performs a local excision of the hemorrhoid under local anesthesia., A 60-year-old female reports a large, painful, thrombosed external hemorrhoid that has persisted for 48 hours. The physician elects to excise the hemorrhoid under local anesthesia, choosing this approach because of the significant pain, although the patient is beyond the ideal 72-hour window., A 28-year-old male presents with a painful external thrombosed hemorrhoid that developed 36 hours prior, accompanied by significant discomfort.After an exam, the physician performs a surgical excision in an outpatient surgical setting under local anesthesia.

** The optimal time frame for excision is within 72 hours of symptom onset. After 72 hours, the benefit of excision might be less than the discomfort caused by the procedure.Consider conservative management if the patient presents beyond the 72-hour window and pain is mild.

  • Revenue Code: P6C (MINOR PROCEDURES - OTHER)
  • Payment Status: Active
  • Specialties:General Surgery, Colorectal Surgery
  • Place of Service:Office, Outpatient Surgery Center, Emergency Room - Hospital
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