Summary & Overview
CPT 46916: Destruction of Anal Lesion Using Cryotherapy
CPT code 46916 covers destruction of anal lesions using cold agents such as liquid nitrogen or carbon dioxide. The procedure is commonly used to treat condyloma, papilloma, molluscum contagiosum, and small herpetic vesicles in outpatient settings. Nationally, this code represents a focused procedural service relevant to colorectal, dermatologic, and general surgical practices and factors into utilization, reimbursement, and access to minor operative treatments.
Key payers in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, typical sites of service, and the payer landscape. The publication summarizes common modifiers and coding considerations, comparisons to related procedural codes, and benchmarks for utilization and reimbursement where available.
This brief prepares clinicians, billing staff, and policy analysts to identify when CPT code 46916 applies, understand which payers commonly cover the service, and locate related coding and policy content in the full publication. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 46916 describes destruction of an anal lesion (for example, condyloma, papilloma, molluscum contagiosum, or herpetic vesicle) using cold substances such as liquid nitrogen or carbon dioxide.
Service Type: Destruction procedure (cryotherapy) of anal lesion
Typical Site of Service: Outpatient procedural settings, commonly performed in ambulatory surgery centers, physician offices (colorectal surgery, dermatology, or primary care procedure rooms), or hospital outpatient departments.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient dermatology or colorectal clinic with one or more small, localized anal lesions suspected clinically to be condyloma acuminata (anogenital warts), molluscum contagiosum, benign papilloma, or a herpetic vesicle. The patient history often includes itching, irritation, bleeding with defecation, or visible papules at the anal verge. Examination by the provider confirms a discrete lesion(s) appropriate for topical destruction.
The clinical workflow begins with history and focused anorectal/skin examination, documentation of lesion size, number, and location, and informed consent for liquid nitrogen (cryotherapy) or other cold-destructive modalities. The provider isolates and visualizes the lesion using appropriate lighting and, if needed, an anoscope for deeper lesions. Lesions are treated with controlled applications of liquid nitrogen spray or cryoprobe; duration and freeze–thaw cycles are documented. Post-procedure instructions address pain control, wound care, signs of infection, and follow-up for recurrence or additional treatments. Procedures are typically performed in an outpatient office or ambulatory surgery setting under local anesthesia only when indicated. Billing uses surgical code 46916 for destruction of an anal lesion by cryotherapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day as a procedure |