Summary & Overview
CPT 46922: Excision or Destruction of Anal Lesion
CPT code 46922 denotes surgical destruction or excision of anal lesions such as condyloma, papilloma, molluscum contagiosum, or herpetic vesicles. This procedure-level code captures a common minor surgical intervention in proctology and dermatologic practice and is relevant to outpatient surgical workflows. Nationally, accurate coding of 46922 affects claims processing, coverage determinations, and resource allocation for ambulatory surgical centers and hospital outpatient departments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, common modifiers associated with procedural coding, and the scope of payers addressed. The publication summarizes benchmark considerations, coding and billing implications for outpatient surgical settings, and policy updates that influence coverage and prior authorization trends. It is intended as a national reference for coding professionals, billing managers, and clinicians seeking clarity on the use and billing context of CPT code 46922.
Billing Code Overview
CPT code 46922 describes the surgical destruction or excision of an anal lesion, such as a condyloma, papilloma, molluscum contagiosum, or herpetic vesicle. The procedure involves removal or destruction of localized lesions in the anal region.
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Service type: Surgical excision / lesion destruction
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Typical site of service: Ambulatory surgery center or hospital outpatient department; may also be performed in an office setting when appropriate
Clinical & Coding Specifications
Clinical Context
A 34-year-old patient presents to an outpatient colorectal clinic with a focal, symptomatic anal condyloma that has persisted despite topical therapy. The evaluation includes history, focused anorectal examination with anoscopy, and photographic documentation. Based on lesion size, location, and patient preference, the colorectal or general surgeon performs operative destruction by surgical excision under local anesthesia with monitored sedation or under general anesthesia if multiple lesions or patient tolerance requires it. The procedure room or ambulatory surgery center is the typical site of service. Routine steps include lesion marking, infiltration with local anesthetic, careful excision with electrocautery or scalpel, hemostasis, specimen handling if pathology indicated, and post-procedure wound care instructions. Peri-procedural documentation includes lesion size, method of destruction, anesthesia administered, specimen disposition, and any immediate complications. Coding uses 46922 for destruction by excision of an anal lesion when operative excision is performed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when 46922 is performed in addition to another procedure on the same day that is not typically reported together and documentation supports distinct service. |