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The procedure described by CPT® Code 46947 refers to a surgical technique known as hemorrhoidopexy, specifically utilizing a stapling method for the treatment of prolapsing internal hemorrhoids. This procedure is designed to address the condition where internal hemorrhoids protrude from the anal canal, causing discomfort and potential complications. During hemorrhoidopexy, a circular hollow tube is introduced into the anal canal, allowing for precise manipulation of the affected tissue. A long suture is strategically placed above the internal hemorrhoids, facilitating the subsequent steps of the procedure. The ends of this suture are then threaded through the hollow tube and out of the anus, which is crucial for the stapling process. The use of a stapler in this context is significant, as it enables the surgeon to effectively reposition the hemorrhoidal cushions back to their normal anatomical location higher within the anal canal. This repositioning is essential for alleviating symptoms associated with hemorrhoidal prolapse. When the stapler is activated, it not only divides the circumferential ring of hemorrhoidal tissue but also staples the upper and lower edges of the divided tissue together. This dual action promotes healing through the formation of scar tissue, which serves to anchor the hemorrhoidal cushions in their corrected position. Over time, as the tissue heals, the staples will naturally detach and be expelled from the body through the stool, completing the process. This method is favored for its minimally invasive nature and the potential for reduced recovery time compared to traditional hemorrhoidectomy techniques.
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The procedure of hemorrhoidopexy using stapling, as described by CPT® Code 46947, is indicated for patients experiencing specific conditions related to internal hemorrhoids. The following indications are explicitly recognized for this procedure:
The hemorrhoidopexy procedure involves several critical steps to ensure effective treatment of prolapsing internal hemorrhoids. The following procedural steps are outlined:
Post-procedure care following hemorrhoidopexy is important for ensuring proper recovery and minimizing complications. Patients may experience some discomfort or pain in the anal area, which can be managed with prescribed pain relief medications. It is also essential for patients to follow any specific instructions provided by their healthcare provider regarding activity restrictions, dietary modifications, and hygiene practices. Monitoring for any signs of complications, such as excessive bleeding or infection, is crucial during the recovery period. Overall, the expected recovery time may vary, but many patients can return to normal activities relatively quickly, depending on their individual circumstances and adherence to post-operative care guidelines.
| Short Descr | HEMORRHOIDOPEXY BY STAPLING | Medium Descr | HEMORRHOIDOPEXY STAPLING | Long Descr | Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 81 - Hemorrhoid procedures |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | SG | Ambulatory surgical center (asc) facility service |
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| 2011-01-01 | Changed | Location in hierarchy changed. |
| 2005-01-01 | Added | First appearance in code book in 2005. |
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