How To Use CPT Code 46020

CPT code 46020 describes the placement of an anal seton, which is a silk and rubber suture used to treat a fistula. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 46020?

CPT 46020 involves the placement of an anal seton, a thread tie used to treat a fistula. This procedure is performed by a physician to maintain drainage and scarring in patients with perianal lesions, such as anal fistulas. The seton is passed through the fistula and tied at a specific tension to prevent abscess formation.

2. Official Description

The official description of CPT code 46020 is the placement of an anal seton. It is important to note that CPT 46020 should not be reported in conjunction with codes 46060, 46280, or 46600.

3. Procedure

1. The physician assesses the patient’s condition and determines the need for the placement of an anal seton.
2. A silk and rubber suture, known as the anal seton, is selected based on the specific requirements of the patient’s fistula.
3. The physician performs the placement of the anal seton, passing it through the fistula and tying it at a tension that allows for drainage and scarring.
4. The seton remains in place for a period of time to facilitate healing and prevent abscess formation.
5. Follow-up appointments may be scheduled to monitor the patient’s progress and make any necessary adjustments to the seton.

4. Qualifying circumstances

CPT 46020 is performed on patients with perianal lesions, specifically anal fistulas, that require the placement of an anal seton. The physician must determine the need for this procedure based on the patient’s condition. It is important to note that CPT 46020 should not be reported in conjunction with codes 46060, 46280, or 46600.

5. When to use CPT code 46020

CPT code 46020 should be used when a physician performs the placement of an anal seton to treat a fistula. It is important to ensure that this code is not reported with codes 46060, 46280, or 46600, as they are not appropriate in conjunction with CPT 46020.

6. Documentation requirements

To support a claim for CPT 46020, the physician must document the following information:

• Patient’s diagnosis and the need for the placement of an anal seton
• Details of the anal seton used, including the type (loose or cutting)
• Date of the procedure
• Specific steps taken during the placement of the anal seton
• Any follow-up appointments or adjustments made to the seton
• Physician’s signature

7. Billing guidelines

When billing for CPT 46020, ensure that the procedure is performed by a physician and that it is not reported in conjunction with codes 46060, 46280, or 46600. It is important to follow the specific guidelines provided by the payer regarding the appropriate use of this code.

8. Historical information

CPT 46020 was added to the Current Procedural Terminology system on January 1, 2002. There have been no updates to the code since its addition.

9. Examples

1. A physician performing the placement of an anal seton for a patient with an anal fistula.
2. A surgeon placing an anal seton to treat a perianal lesion in a patient.
3. A gastroenterologist performing the placement of an anal seton for a patient with a complex fistula.
4. A colorectal surgeon using CPT 46020 to treat a patient with a recurrent anal fistula.
5. An attending physician performing the placement of an anal seton for a patient with a chronic perianal abscess.
6. A proctologist using CPT 46020 to treat a patient with a complex anal fistula.
7. A general surgeon performing the placement of an anal seton for a patient with a perianal lesion.
8. A colorectal specialist using CPT 46020 to treat a patient with a recurrent anal fistula.
9. An attending physician performing the placement of an anal seton for a patient with a complex perianal abscess.
10. A surgeon using CPT 46020 to treat a patient with a chronic anal fistula.