Code Details & Principles for H4130
Code details & principles for
H4130
- Chapter 11 / Rectum/Anus
| Code | Description | Chapter/Sub-Chapter | Code Specific Guidance |
|---|---|---|---|
| H4130 | Perianal excision of lesion of rectum (including sigmoidoscopy) | 11.6.0 Rectum/Anus |
Unacceptable Combinations for H4130
| CCSD Code (unacceptable combination) | Narrative (unacceptable combination) | Date Added |
|---|---|---|
| H2502 | Diagnostic flexible sigmoidoscopy (including forceps biopsy and proctoscopy) | 2014-03-04 |
| H2510 | Rigid sigmoidoscopy (including proctoscopy and biopsy) | 2013-07-23 |
| H3383 | Robotic assisted total mesorectal excision (TME) | 2020-05-19 |
| H3384 | Open Total Mesorectal Excision (TME) | 2020-08-06 |
| H3385 | Laparoscopic total mesorectal excision (TME) | 2020-08-06 |
| H3386 | Transanal Total Mesorectal Excision (TME) | 2020-08-06 |
| H3400 | Open excision of lesion of rectum and colon | 2010-01-20 |
| H4000 | Transanal resection for rectal cancer | 2010-01-20 |
| H4122 | Transanal endoscopic microsurgery | 2010-01-20 |
| H4180 | Full or partial thickness rectal biopsy | 2010-01-20 |
| H4190 | Therapeutic High Resolution Anoscopy (HRA) in symptomatic patients (+/- biopsy or ablation of lesion of anus) | 2012-10-31 |
| H4430 | Examination of rectum under anaesthetic (as sole procedure) | 2013-06-03 |
| H4480 | Dilation of stricture of rectum | 2010-01-20 |
| H4800 | Excision of lesion of anus | 2010-01-20 |
| H4900 | Destruction of lesion of anus | 2010-01-20 |
| H5043 | Primary repair of low congenital ano-rectal anomaly | 2010-01-20 |
| H5400 | Anorectal stretch | 2010-01-20 |
| H6260 | Proctoscopy (+/- biopsy) | 2012-02-27 |
| H6261 | Video-assisted proctoscopy | 2023-04-14 |
Coding Principles
These coding principles set out how the authors intend that the codes and narratives within the CCSD Schedule are interpreted and used. The outputs are available to be used by all individual insurers and providers including CCSD and non-CCSD members. Please note that:
- The CCSD Group does not discuss nor determine classifcations, reimbursement or fees - all insurers will have their own view on these matters
- The inclusion of a procedure code and/or its associated coding principles in the CCSD Schedule does not necessarily mean that it is endorsed by all members of the CCSD Group and codes may or may not be included in individual insurers' own Schedules or covered
- The coding principles are non-exhaustive guidelines only - each individual insurer may choose whether or not to adopt an individual combination of codes in practice and you will need to contact the insurer for further information