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Banding Bulletin – February 2017

Banding Bulletin – February 2017

We hope that this edition of the Banding Bulletin finds you well! We’ve received a few inquiries about a new CMS rule that has been floating around that pertains to hemorrhoid ligation and so we’ll start off by trying to clear that up for you!

Global Surgery Data Collection Rule

Many of you have received letters or emails regarding a new CMS rule for several surgical procedures, including the CPT code 46221 (Hemorrhoid Band Ligation). A brief overview of the rule can be found on the AGA website where they indicate that new tracking requirements for these procedures will be effective July 1st, 2017. As it turns out, this new requirement should rarely pertain to most of you, but we’ll provide some clarification below.

This new rule only pertains to you if:

  • Your practice has 10 or more practitioners, AND
  • Your practice is located in one of the following 9 states: FL, KY, LA, NV, NJ, ND, OH, OR, RI

If you don’t fall into BOTH of the above groups, feel free to skip down to the next section of the Bulletin!

If you are practicing in one of the above-mentioned states AND your group has 10 or more practitioners, then beginning 7/1/17, you should begin to include a post-operative visit code for any follow-up visit that would fall within the global period for the procedure (10 days for 46221). This should be a very rare occurrence, but IF a banding patient is seen again within 10 days following the procedure, CPT code 99024 will need to be reported with a reimbursement value of $0.00.

CMS has stated that the new rule is due to the planned removal of global periods on these procedures. Since 99024 is currently bundled with the procedure, they need to determine a fair valuation for these CPT codes and will do so by determining how frequently these post-op visit codes are occurring (as they are not currently being reported).

To summarize, this rule should rarely come into play, and then only for folks in larger groups in the selected states. We hope that this clears things up for you, but if you require more information or have any other questions regarding this, please contact SHAUN GERRITS or ME at your convenience.

Anesthesia and Endoscopy

CRH Anesthesia continues to grow its presence as an anesthesia services manager and partner. We are now partners in 26 endoscopy centers in 7 States and are interested in further expansion.

If you have a current anesthesia program and would like to monetize some of the equity that you’ve built up in the service, we would love to speak with you! If you are interested in bringing your anesthesia in-house we’d be glad to work with you so that you can maximize your benefit from anesthesia in the future.

For more information, please contact Carter Blanton at or (615) 364-9707.

CRH Coming to a Conference Near You!

CRH will have representatives attending a number of conferences in the coming weeks:

  • NCSG Annual Conference this weekend in Pinehurst, NC
  • ACG/FGS Spring Symposium in Clearwater, FL from Feb 24-26
  • ACG/LGS Regional Postgraduate Course in New Orleans from March 3-4
  • ACG Western Regional Postgraduate Course in Las Vegas from March 10-12
  • GI Roundtable in Fort Worth, TX from March 17-18

Please stop by as we’ll be there ready to address any questions you might have and to provide you with more information on both the “hemorrhoid side” and the “anesthesia side” of things. Safe travels!!

Let us know how we can help!

We would love the chance to visit with you at your practice! If you’d like to schedule a training or “refresher” session, if you’d like an in-person demonstration of the NEW CRH O’Regan System, or if you have a friend or colleague who would like to bring these procedures into their practice, please contact ME and we’ll get you on our calendar.

Thanks for checking into this Banding Bulletin – we look forward to catching up with you soon.


Mitchel Guttenplan, MD, FACS
Medical Director
CRH Medical Corporation
C: 770.363.0125 F: 770.475.9953

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