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Banding Bulletin – September 2010

Banding Bulletin – September 2010

I hope that this month’s edition of the Banding Bulletin finds you well! Over the past few weeks we have had the chance to catch up with a number of our Partner Physicians, and I’d like to dedicate this Bulletin to a few recurring themes that we most often encounter, from clinical, practice management and billing/coding perspectives.

From a clinical perspective, we have a tremendous amount of didactic and other support materials available on our professional website, but if you are not able to find what you need, or if you still have questions, PLEASE CONTACT US. Andy Gorchynsky and I are always available to address any questions that might arise, and we are available to you on a “24/7” basis by phone or email — please take full advantage of these resources if we can help!

We also know that many of you are trying to build your banding practice, and we have numerous resources available to you in order to help identify patients in need of therapy as well as to market these services to other physicians in your area. We’d like you to remember that we also offer our web-marketing services to you FREE OF CHARGE, and many of our Partners have experienced a tremendous response from their participation. Our consumer-based website is garnering more than 20,000 visitors each month, and we have been passing along over 1,100 new patient leads generated from this website PER MONTH! I know that I have received solicitations from several internet marketing companies in the past month offering similar services at a considerable cost, so we’d like to encourage you to participate in our free program. There are multiple ways to successfully create a cost-effective, integrated marketing program within your community, and free, ongoing consultation with our resident marketing expert Alicia Johnson is also available to help you navigate this often confusing, yet effective terrain. Please contact her today to discuss all of the free resources that we offer your practice.

We also receive billing and coding questions, as well as questions regarding the performance of these procedures in an ASC setting. The following comes from our Billing/Coding expert, Sarah Standley, who is available to address any questions that might arise in this area.

Medicare began allowing the procedure to be performed in an ASC setting as of January 1, 2008 when they added CPT 46221 to the ‘Revised Final ASC Covered Surgical Procedures.’ The current CY 2010 list can be viewed here. With little patient prep, no fasting required and a very short procedure time, the ligation can be scheduled during periods of vacant capacity and can be performed in any of your patient venues including endo as well as pre and post endo areas. Our partner physician practices have been able to successfully receive reimbursement for both the professional fee and the facility fee with the vast majority of insurance plans (TRICARE being a notable exception).

The procedure can also be easily performed in an office setting or a combination of locations. Though a modifier is not necessary when billing for the ligation (CPT 46221), they are necessary when billing for additional services (i.e. office visit, proctoscopy (CPT 45300) or anoscopy (CPT 46600). With sufficient supporting documentation, an office visit and a proctoscopy are typically reimbursed, whereas the anoscopy is frequently bundled with the main procedure. When supporting an office visit, the documentation should support a significant and separately identifiable service/diagnosis. These other diagnoses most frequently include anal fissure, anal spasm, skin rash, IBS, constipation or diarrhea.

Regardless of which location the procedure is performed, CPT 46221 is considered a minor procedure and carries a 10 day global period.

Please see our billing reference guide to review our most frequently asked questions.

To discuss these items or review any other billing, reimbursement or coding questions please contact via email Sarah Standley or call 800.660.2153 x1029.

You will be receiving additional notification from us in a week or two, but if you will be in San Antonio for the ACG meeting in October, please stop by our booth #1138 in the exhibition center, as we’d love to say “hello” and address any questions that you might have. Have a great month, and please let us know if we can help in any way.

Know someone who would be interested in the CRH O’Regan System Partnership Program?

Use the “Share with a colleague” function on the right, or send me an email. We are happy to introduce your colleagues to the benefits of the program.

Training and Support Resources

If you or your practice have any clinical questions/concerns, are ready to expand your practice by having additional doctors trained, or simply want a follow-up training session for yourself, please do not hesitate to contact me. If your practice needs help with any other resources, below is a quick reference to the departments that are here to support you:

Marketing: Alicia Johnson (800.660.2153 x1029)

Product Ordering: Deborah Cotter (800.660.2153 x1011)

Front Office Staff Training: Kelley Mamelson (800.660.2153 x1029)

Contracting and Billing: Sarah Standley (800.660.2153 x1029)

Please let us know how we can help to support you and your practices moving forward – whether it be for training, consultation, operational, billing/coding or marketing support – we are here to help in any way we can!

Best regards,


Mitchel Guttenplan, MD, FACS

Medical Director

CRH Medical Corporation

T: 800.660.2153 x1022 | C: 770.363.0125 | F: 770.475.9953

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