Summary & Overview
CPT 46230: Excision of Multiple External Anal Papillae (Skin Tags)
CPT code 46230 denotes surgical removal of multiple external anal papillae (skin tags), commonly associated with the external edge of an anal fissure or fistula. This procedure matters nationally because it is part of routine anorectal surgical care that can affect outpatient surgical volumes, resource use in ambulatory settings, and coding clarity for procedures addressing symptomatic perianal lesions. Clear coding supports appropriate clinical documentation and payer adjudication for minor anorectal surgeries.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes how payers generally classify and reimburse minor anorectal excisions, highlights common billing considerations, and outlines typical sites of service.
Readers will learn the clinical context for use of CPT code 46230, expected service settings (ambulatory surgical center or outpatient clinic), and how this code fits into broader anorectal procedural coding. The report provides benchmarks for utilization where available, notes relevant policy updates affecting ambulatory surgical procedures, and explains documentation elements important for coding accuracy. Data not available in the input are explicitly noted where applicable.
Billing Code Overview
CPT code 46230 describes a procedure for removal of multiple external anal papillae or skin tags. These lesions are typically excised when present on the external edge of an anal fissure or fistula and are removed to address symptomatic irritation or to facilitate management of the underlying anorectal condition.
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Service type: Surgical excision of external anal papillae/skin tags
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Typical site of service: Ambulatory surgical center or outpatient clinic procedure room
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 42-year-old adult who presents to a colorectal clinic with recurrent anal discomfort and hygiene difficulty related to multiple external skin tags at the anal verge. The patient reports intermittent pain, snagging during bowel movements, and cosmetic concern. Examination reveals several pedunculated fibroepithelial skin tags clustered at the external edge of a chronic anal fissure. The colorectal surgeon reviews history and performs anoscopy to evaluate for fissure or fistula. After local anesthesia (field block) and appropriate positioning in the prone jackknife or lithotomy position, the provider excises multiple small external papillae/skin tags using scissors or electrocautery, achieves hemostasis, and applies topical therapy or wound dressing. The patient receives post-procedure instructions for wound care, stool softeners, and signs of complications. Billing reflects minor outpatient procedure work at an ambulatory surgery center, office-based procedure room, or hospital outpatient department depending on setting and anesthesia used. Payers commonly involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Increased procedural services | Use when service requires substantially greater work than typical for 46230. |