Summary & Overview
CPT 46900: Chemical Destruction of Anal Lesion
CPT code 46900 represents a simple chemical destruction procedure for anal lesions such as condyloma, papilloma, molluscum contagiosum, or herpetic vesicles. This minor dermatologic/proctologic intervention is commonly performed in outpatient clinic or office procedural settings and is relevant to clinicians, billing professionals, and payers because correct coding affects claims adjudication and clinical documentation requirements nationwide.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical indication and typical setting for use of CPT code 46900, a synthesis of common billing and documentation considerations, and benchmarks where available. The summary highlights typical use cases and what to expect in payer coverage patterns for minor anal lesion destruction.
The publication provides practical reference material: an explanation of the code definition, service type and site-of-service implications, payer coverage landscape, and related billing considerations. Data not available in the input is noted when applicable, and the material is presented for a national audience without state-specific guidance.
Billing Code Overview
CPT code 46900 describes a simple chemical destruction of an anal lesion, such as a condyloma, papilloma, molluscum contagiosum, or herpetic vesicle. The procedure involves application of a chemical agent to ablate superficial lesions in the anal region.
Service type: Procedure — minor cutaneous/dermatologic lesion destruction
Typical site of service: Outpatient clinic or office-based procedure room, including dermatology, proctology, or primary care settings where minor operative procedures are performed.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who presents to an outpatient colorectal clinic or dermatology/proctology office with one or more small external or peri-anal verrucous lesions suspicious for condyloma acuminata (anogenital warts), papilloma, molluscum contagiosum, or occasionally a herpetic vesicle that is painful or persistent. The provider performs an exam of the perianal region, documents lesion size, number, location, and patient symptoms (itching, bleeding, pain). After informed consent and explanation of alternatives, the clinician applies a topical chemical agent (commonly trichloroacetic acid or podophyllin is not a chemical destruction; for 46900 typically caustic chemical) to each lesion to chemically destroy the superficial tissue. The procedure is brief, often performed in an exam room under direct visualization with appropriate lighting and cleansing; no general anesthesia is required. Post-procedure instructions include wound care, expected local reaction, signs of infection, and potential need for repeat treatment at follow-up if lesions persist. Typical sites of service are outpatient clinic, ambulatory surgical center for multiple or extensive lesions, or office-based procedural room.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when an E/M is medically necessary and documented separately from the procedure visit leading to . |