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Tip: Understand the Medicare coverage changes for hemorrhoid procedures

Ambulatory Surgery Reimbursement Update, November 25, 2008

Medicare has made some significant changes to the coverage of hemorrhoid procedures performed in ASCs for 2009. For example, Medicare has removed the following codes from the Medicare list of covered procedures effective January 1, 2009:

  • 46934—(destruction of hemorrhoids, any method; internal)
  • 46935—(destruction of hemorrhoids, any method; external)
  • 46936—(destruction of hemorrhoids, any method; internal and external)

These three codes will not appear in your 2009 CPT Manual. They have been replaced with code 46930 (destruction of internal hemorrhoid(s) by thermal energy [e.g., infrared coagulation, cautery or radiofrequency]). Medicare reimburses this new code at $127.68 nationally.

This tip is brought to you by Ellis Medical Consulting, Inc.