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Official Description

Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 46922 refers to the procedure for the destruction of lesions located in the anal region, specifically through surgical excision. This procedure is utilized to remove one or more types of anal lesions, which may include condyloma (warts caused by human papillomavirus), papilloma (benign tumors), molluscum contagiosum (a viral skin infection), and herpetic vesicles (blisters caused by the herpes virus). During the procedure, the physician evaluates the lesion to determine the most suitable method of destruction. Local anesthesia is administered as necessary to ensure patient comfort during the procedure. The excision involves making a full-thickness incision through the mucous and submucous tissue surrounding the lesion, allowing for complete removal. The excised lesion is then sent for histologic evaluation to assess its nature. This procedure is part of a broader category of treatments for anal lesions, which may also include chemical destruction, electrodessication, cryosurgery, and laser surgery, each with its specific techniques and indications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 46922 is indicated for the treatment of various anal lesions. These include:

  • Condyloma - Warts caused by human papillomavirus, which can appear in the anal area.
  • Papilloma - Benign tumors that may develop in the anal region.
  • Molluscum contagiosum - A viral infection that leads to the formation of small, raised lesions.
  • Herpetic vesicle - Blisters that occur due to herpes virus infection, which can affect the anal area.

2. Procedure

The procedure for CPT® Code 46922 involves several key steps to ensure the effective excision of the anal lesion:

  • Step 1: Preparation - The physician prepares the patient by administering local anesthesia to minimize discomfort during the procedure. This step is crucial for ensuring that the patient remains comfortable throughout the excision process.
  • Step 2: Identification of the Lesion - The physician carefully examines the lesion to determine its size and location. This assessment helps in planning the excision and ensuring that a narrow margin of healthy tissue is included in the incision.
  • Step 3: Incision - A full-thickness incision is made through the mucous and submucous tissue surrounding the lesion. The incision is designed to encircle the lesion, allowing for complete removal.
  • Step 4: Excision - The entire lesion is excised, ensuring that no remnants are left behind. This step is critical for preventing recurrence and ensuring complete removal of the affected tissue.
  • Step 5: Hemostasis - After excision, bleeding is controlled using electrocautery or chemical cautery. This step is essential to minimize blood loss and promote a clean surgical field.
  • Step 6: Wound Closure - The wound may be closed using a simple single-layer suture technique, or it may be left open to granulate, depending on the physician's assessment and the specific circumstances of the excision.
  • Step 7: Histologic Evaluation - The excised lesion is sent to the laboratory for histologic evaluation. This evaluation is important for determining the nature of the lesion and ensuring appropriate follow-up care.

3. Post-Procedure

Post-procedure care for CPT® Code 46922 includes monitoring the surgical site for signs of infection and ensuring proper healing. Patients may be advised on wound care, including keeping the area clean and dry. Follow-up appointments may be scheduled to assess healing and discuss the results of the histologic evaluation. Patients should also be informed about potential signs of complications, such as increased pain, swelling, or discharge, and instructed to contact their healthcare provider if these occur.

Short Descr EXCISION OF ANAL LESION(S)
Medium Descr DSTRJ LESION ANUS SIMPLE SURG EXCISION
Long Descr Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision
Status Code Active Code
Global Days 010 - Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6C - Minor procedures - other (Medicare fee schedule)
MUE 1
CCS Clinical Classification 95 - Other non-OR lower GI therapeutic procedures
GC This service has been performed in part by a resident under the direction of a teaching physician
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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