CPT® Code 46320

Excision of a thrombosed hemorrhoid, classified under CPT® Code 46320, refers to a surgical procedure aimed at removing an external hemorrhoid that has developed a blood clot, leading to significant discomfort and pain. External hemorrhoids are swollen blood vessels located outside the anal canal, and when they become thrombosed, they can cause severe tenderness, making activities such as sitting, walking, or passing stool quite challenging for the patient. The procedure begins with a thorough examination of the perianal tissue to assess the extent of hemorrhoidal disease, often utilizing an anoscope for better visualization. Prior to the excision, the perianal skin and anal canal are meticulously cleansed, and a local anesthetic is administered at the base of the hemorrhoid to ensure patient comfort during the procedure. To enhance visibility and access to the hemorrhoid, a clamp may be applied to the skin. The surgeon then makes a radial or circumferential incision over the thrombosed hemorrhoid to effectively remove the blood clots. The excision is performed using an elliptical incision that fully encompasses the external hemorrhoid. After the hemorrhoidal plexus and any clots are excised, the base of the wound is carefully examined for any remaining hemorrhoidal tissue or clots, which are also removed. To manage any bleeding that may occur during the procedure, techniques such as applying pressure or using electrocautery are employed. Finally, the surgical wound may either be sutured closed or left open to allow for natural healing, depending on the specific circumstances of the case.