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2025 CPT code 46946

Hemorrhoidectomy, internal, by ligation (other than rubber band); 2 or more hemorrhoid columns/groups.

Follow CPT guidelines for hemorrhoidectomy procedures, ensuring accurate documentation of the technique used and the number of hemorrhoids treated.Appropriate modifiers may apply depending on the circumstances.

Modifiers may be applicable depending on the specifics of the procedure and the circumstances. Consult the CPT manual and payer guidelines for appropriate modifier usage.

Medical necessity is established when the patient experiences clinically significant symptoms (bleeding, pain, prolapse, or other discomfort) related to internal hemorrhoids that significantly impact their quality of life and do not respond to conservative management.

The surgeon performs the hemorrhoidectomy using an appropriate ligation technique, ensuring proper patient preparation, anesthesia, and hemostasis (control of bleeding).

IMPORTANT:Do not report 46221, 46945, 46946 in conjunction with 46948. Do not report 46945, 46946 in conjunction with 76872, 76942, 76998.For excision of internal and/or external hemorrhoid(s), see 46250-46262, 46320. For injection of hemorrhoid(s), use 46500. For destruction of internal hemorrhoid(s) by thermal energy, use 46930. For destruction of hemorrhoid(s) by cryosurgery, use 46999. For transanal hemorrhoidal dearterialization, including ultrasound guidance, with mucopexy, when performed, use 46948. For hemorrhoidopexy, use 46947.

In simple words: This code describes a surgical procedure to remove two or more hemorrhoids (swollen veins in the anus and rectum) using methods like tying them off with stitches or injecting medicine to shrink them.It doesn't include the rubber band ligation method.

This CPT code, 46946, represents the surgical removal of two or more internal hemorrhoids or groups of hemorrhoids using a ligation technique other than the rubber band method.The procedure involves the ligation (tying off) of the hemorrhoidal vessels to control bleeding and remove the hemorrhoids.Various techniques, such as transfixion suture excision or sclerotherapy, may be employed.

Example 1: A 45-year-old patient presents with symptomatic internal hemorrhoids (bleeding, pain, prolapse).The surgeon performs a hemorrhoidectomy using transfixion sutures and ligation to remove three hemorrhoid columns., A 60-year-old patient with multiple symptomatic internal hemorrhoids undergoes sclerotherapy with subsequent ligation of the treated hemorrhoids.The procedure addresses several hemorrhoidal clusters., A 38-year-old pregnant patient experiencing significant discomfort from several internal hemorrhoids chooses a less invasive ligation method (other than rubber band) after delivery for the removal of two clusters.

* Preoperative evaluation and assessment of hemorrhoids.* Detailed operative report describing the technique used (e.g., transfixion suture ligation, sclerotherapy).* Number of hemorrhoid columns/groups treated.* Intraoperative and postoperative findings.* Pathology report (if applicable).

** This code excludes the use of rubber band ligation. Always document the specific ligation technique utilized for accurate coding.

  • Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
  • Payment Status: Active
  • Modifier TC rule: Not applicable.
  • Specialties:General Surgery, Colorectal Surgery
  • Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)
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