CPT® 46946 with modifier 51

Hello, I am new to surgical billing. I have noticed that I am not getting paid for CPT® 46946 with modifier 51. The first line billed with 46946 will pay but not the second line 46946 with 51.... Am i using the correct modifier? Thanks

re: CPT® 46946 with modifier 51

46946 is for the ligation of two or more columns or groups of hemorrhoids, so my question is how many were remove and why are you using modifier 51 for multiple procedures. I'm not quite sure why you are billing this procedure out like this, if two or more hemorrhoids were removed 46946 should only be billed once.

re: CPT® 46946 with modifier 51

Only 2 were removed. And they were not from a group/column. I was billing this with modifier 51 bc the former biller had done it this way. So bc two were removed in the same surgery, I should only bill 46946 alone, once, with no modifier?

Thanks!

re: CPT® 46946 with modifier 51

That would be correct, go to the Surgery(digestive system-pg 203, code is out of sequence) section of the CPT® book and read the definition of the code and correct, no modifier. You should also go to the back of the book and read up on the correct use of modifiers Appendix A, pg 453. I am using the CPT® book 2015



Just another thought, is the provider removing internal or exteranl hemrrhoids and how are they being removed(cauteraztion, rubber band...etc)

re: CPT® 46946 with modifier 51

I read throught he operative and all it states is that the removal was through Ligasure....

re: CPT® 46946 with modifier 51

do you mean ligature??, using a thread or wire for tying a vessel or to constrict a part....

re: CPT® 46946 with modifier 51

if your provider did a hemorrhoidectomy, internal by rubber band ligation(s) then the correct CPT® code to use would be 46221. if he did it by ligation other than rubber bands, 2 or more hemorrhoid columns/groups, then the correct code would be the 46946