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July 27, 2016

Hemorrhoid Artery Ligation Coverage Guidelines

CGS will cover CPT code 0249T (ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance) retroactively, for dates of service on or after January 1, 2014. CGS will allow services for Doppler-guided hemorrhoid artery ligation with or without retro-anal repair for Grade II or III hemorrhoids that have failed rubber band ligation and/or conservative treatment.

Conservative treatment includes behavior modification, high fiber diets to control constipation, and hydrocortisone cream or suppositories.

Based on the AMA CPT book, it is not appropriate to submit the following CPT codes in addition to CPT code 0249T: 46020, 46221, 46250-46262, 46600, 46945, 46946, 76872, 76942, and 76998.

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