Local Coverage Article Billing and Coding

Billing and Coding: Hemorrhoid Artery Ligation


Expand All | Collapse All

Contractor Information

Article Information

General Information

Article ID
Article Title
Billing and Coding: Hemorrhoid Artery Ligation
Article Type
Billing and Coding
Original Effective Date
Revision Effective Date
Revision Ending Date
Retirement Date
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2022 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

Current Dental Terminology © 2022 American Dental Association. All rights reserved.

Copyright © 2023, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB‐04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312‐893‐6816.

Making copies or utilizing the content of the UB‐04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB‐04 Manual and/or codes and descriptions; and/or making any commercial use of UB‐04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. The views and/or positions presented in the material do not necessarily represent the views of the AHA. CMS and its products and services are not endorsed by the AHA or any of its affiliates.

CMS National Coverage Policy

Title XVIII of the Social Security Act §1833(e)

Article Guidance

Article Text

Effective 08/11/2011, Palmetto GBA will reimburse services for doppler-guided hemorrhoid artery ligation with or without retroanal repair for Grade II or III hemorrhoids that have failed rubber band ligation or conservative treatment, such as behavior modification, high fiber diets to control constipation, and hydrocortisone cream/suppositories.

To submit claims for this service, submit code 46948.

According to CPT® coding references, it is not appropriate to submit the following codes with a 46948 service: 46020, 46221, 46250, 46255, 46257, 46258, 46260, 46261, 46262, 46600, 46945, 46946, 76872, 76942, and 76998.



Coding Information


Group 1

(16 Codes)
Group 1 Paragraph


Group 1 Codes
46020 Placement of seton
46221 Ligation of hemorrhoid(s)
46250 Remove ext hem groups 2+
46255 Remove int/ext hem 1 group
46257 Remove in/ex hem grp & fiss
46258 Remove in/ex hem grp w/fistu
46260 Remove in/ex hem groups 2+
46261 Remove in/ex hem grps & fiss
46262 Remove in/ex hem grps w/fist
46600 Diagnostic anoscopy spx
46945 Int hrhc lig 1 hroid w/o img
46946 Int hrhc lig 2+hroid w/o img
46948 Int hrhc tranal dartlzj 2+
76872 Us transrectal
76942 Echo guide for biopsy
76998 Us guide intraop

CPT/HCPCS Modifiers


ICD-10-CM Codes that Support Medical Necessity


ICD-10-CM Codes that DO NOT Support Medical Necessity


Additional ICD-10 Information


Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.


Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.


Other Coding Information


Revision History Information

Revision History DateRevision History NumberRevision History Explanation
01/01/2020 R6

Under Article Title changed title to, “Billing and Coding: Hemorrhoid Artery Ligation”. Under Article Text deleted CPT® code 0249T that is mentioned throughout the text and replaced it with CPT® code 46948. Under CPT/HCPCS Codes Group 1: Codes added CPT® code 46948. CPT® code 0249T was deleted. The code descriptions for CPT® codes 46945 and 46946 were revised. This revision is due to the Annual CPT®/HCPCS Code Update and becomes effective on 1/1/2020.

10/03/2019 R5

This article is being revised in order to adhere to CMS requirements per Chapter 13, Section 13.5.1 of the Program Integrity Manual. Title XVIII of the Social Security Act §1833(e) has been added to the CMS National Coverage Policy section and removed from the Statutory Requirements section. Under Article Title changed title from “Hemorrhoid Artery Ligation CPT Code 0249T Article” to “Billing and Coding: Hemorrhoid Artery Ligation CPT Code 0249T”.

03/15/2018 R4

Revisions were made to the Hemorrhoid Artery Ligation CPT Code 0249T Article A53006. Under CPT/HCPCS Codes added CPT codes included in the Article Text.

At this time 21st Century Cures Act will apply to new and revised LCDs that restrict coverage which requires comment and notice. This revision is not a restriction to the coverage determination; and, therefore not all the fields included on the LCD are applicable as noted in this policy.


02/26/2018 R3 The Jurisdiction "J" Part B Contracts for Alabama (10112), Georgia (10212) and Tennessee (10312) are now being serviced by Palmetto GBA. Effective 02/26/18, these three contract numbers are being added to this article. No coverage, coding or other substantive changes (beyond the addition of the 3 Part B contract numbers) have been completed in this revision.
03/10/2016 R2 Under Article Text added “…coding references…” to the third sentence and deleted the cited reference. Under CPT/HCPCS Codes Group 1: Paragraph deleted the statement as it was redundant.
10/01/2015 R1 In Additional Documents added SSA Citations. Added HCPCS codes from Article Text to the HCPCS Coding section.

Associated Documents

Related Local Coverage Documents
Related National Coverage Documents
Rules and Regulations URLs
CMS Manual Explanations URLs
Other URLs
Public Versions
Updated On Effective Dates Status
12/12/2019 01/01/2020 - N/A Currently in Effect You are here
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.


  • Hemorrhoid Artery Ligation
  • Hemorrhoid