ASGE members may submit coding inquiries electronically to codingquestions@asge.org. When submitting a question, please allow at least three business days for a response. When submitting inquiries, please include the ASGE member’s name and ID number. Only questions will be accepted and not reports. Below is our featured Coding Question of the Month that could be beneficial to your practice.

Question

One of my providers asked me if he could bill code 46221 more than one time per visit with different degrees of hemorrhoids, for example, codes 46221 K64.1 and 46221-59 K64.2. I entered this into coding software, and it said there was no problem with the claim. This seemed unusual to me. Can you verify that billing these codes together is allowed?

Answer

Yes, surprisingly, there isn't an edit for this one. The CPT code 46221 (hemorrhoidectomy, internal, by rubber band ligation[s]) is plural, meaning this includes more than one. Per the 2024 Medicare Medically Unlikely Edits (MUEs) effective April 1, 2024, there is a limit of one billed per encounter.