How To Use CPT Code 46220

CPT 46220 describes the excision of a single external papilla or tag from the anus. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 46220?

CPT 46220 is used to describe the surgical removal of an external abnormal growth, known as an external papilla or skin tag, from the anal area. This procedure is typically performed to address lesions that are associated with the external edge of an anal fissure or fistula.

2. Official Description

The official description of CPT code 46220 is the “Excision of single external papilla or tag, anus.” This code specifically refers to the removal of a single abnormal growth from the anal area.

3. Procedure

1. During the procedure, the healthcare provider first ensures that the patient is appropriately prepped and anesthetized.
2. The provider then identifies the external papilla or skin tag in the anal area.
3. Using forceps, the provider grasps the papilla or tag and crushes it.
4. Once the abnormal growth is crushed, the provider excises it using surgical scissors or a surgical loop made of metal wire.
5. After the excision, the provider may apply antibiotics to the area to prevent infection.

4. Qualifying circumstances

CPT 46220 is performed when there is a need to remove a single external papilla or tag from the anus. These growths are often associated with the external edge of an anal fissure or fistula. The procedure is typically performed by a healthcare provider who is qualified to perform surgical excisions.

5. When to use CPT code 46220

CPT code 46220 should be used when a healthcare provider performs the excision of a single external papilla or tag from the anus. It is important to note that this code is specific to the removal of a single abnormal growth and should not be used for multiple lesions.

6. Documentation requirements

To support a claim for CPT 46220, the healthcare provider must document the following information:

• Patient’s diagnosis and the medical necessity for the excision
• Date of the procedure
• Details of the excision, including the specific papilla or tag removed
• Any additional procedures performed during the same session
• Any complications or post-operative care provided
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 46220, ensure that the procedure performed is the excision of a single external papilla or tag from the anus. It is important to follow the specific documentation requirements and guidelines set forth by the payer. Additionally, consider any applicable modifiers or bundling rules when reporting this code.

8. Historical information

CPT 46220 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs the excision of a single external papilla from the anus of a patient with an anal fissure.
2. During a surgical procedure, a provider removes a single skin tag from the anal area of a patient with a history of anal fistula.
3. A healthcare provider performs the excision of a single external papilla from the anus of a patient with chronic anal discomfort.
4. During a routine examination, a provider identifies and removes a single skin tag from the anal area of a patient.
5. A healthcare provider performs the excision of a single external papilla from the anus of a patient with recurrent anal itching.
6. During a surgical procedure, a provider removes a single skin tag from the anal area of a patient with a history of anal fissure.
7. A healthcare provider performs the excision of a single external papilla from the anus of a patient with an anal fistula.
8. During a routine examination, a provider identifies and removes a single skin tag from the anal area of a patient with chronic anal discomfort.
9. A healthcare provider performs the excision of a single external papilla from the anus of a patient with recurrent anal itching.
10. During a surgical procedure, a provider removes a single skin tag from the anal area of a patient with a history of anal fissure.