CPT® Code 46946

Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups, without imaging guidance

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, pain, and irritation. 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 hemorrhoidal 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 securely grasped with forceps, and a ligature device, which is not a rubber band, is placed around the base of the hemorrhoid. This ligature is crucial for interrupting the blood supply to the hemorrhoid, effectively leading to its removal. To further ensure the success of the procedure, a second ligature is applied just below the first, providing an additional safeguard in case the first ligature fails. This procedure is specifically coded as CPT® 46946 when two or more hemorrhoid columns or groups are treated by ligation without the use of imaging guidance.