CPT® Code 46945

Hemorrhoids are swollen blood vessels located in the anal region, which can lead to discomfort and various symptoms. Internal hemorrhoids specifically refer to those that develop inside the anal canal, often causing issues such as bleeding or pain during bowel movements. The evaluation of hemorrhoidal disease typically involves a thorough examination of the perianal tissue, which is conducted using specialized instruments like an anoscope or proctoscope. This examination helps determine the extent of the condition. Prior to the procedure, the perianal skin and anal canal are meticulously cleansed to minimize the risk of infection. A local anesthetic is then 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 utilized to provide traction to the surrounding skin. The hemorrhoid is then carefully grasped with forceps, and a ligation device, which is not a rubber band, is applied around the base of the hemorrhoid. This ligature is crucial as it interrupts the blood supply to the hemorrhoid, effectively treating the condition. A second ligature is placed just below the first to provide additional security, ensuring that the blood flow is sufficiently obstructed even if one ligature fails. The CPT® Code 46945 is specifically designated for the treatment of a single hemorrhoid column or group using this ligation method without the aid of imaging guidance. In contrast, for cases involving two or more hemorrhoid columns or groups, the appropriate code to use is 46946.