How To Use CPT Code 46900

CPT 46900 describes the destruction of anal lesions using a chemical agent. 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 46900?

CPT 46900 can be used to describe the destruction of anal lesions using a chemical agent. This code is used when a provider applies a caustic agent, such as bichloracetic acid or dichloroacetic acid, to lesions on the perianal skin, causing them to be burned and destroyed.

2. Official Description

The official description of CPT code 46900 is: ‘Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical.’

3. Procedure

1. The provider identifies the anal lesions, such as condyloma, papilloma, molluscum contagiosum, or herpetic vesicle, on the perianal skin.
2. A chemical agent, such as bichloracetic acid or dichloroacetic acid, is selected.
3. The provider applies the caustic agent to the lesions, allowing it to penetrate the skin and cauterize the lesions.
4. The chemical agent destroys the lesions, resulting in their removal from the anus.

4. Qualifying circumstances

Patients eligible to receive CPT 46900 services are those with anal lesions, such as condyloma, papilloma, molluscum contagiosum, or herpetic vesicle, that require destruction. The provider must use a chemical agent, such as bichloracetic acid or dichloroacetic acid, to perform the procedure.

5. When to use CPT code 46900

CPT code 46900 should be used when a provider performs a simple chemical destruction of anal lesions using a caustic agent. This code is appropriate for cases where the lesions are not extensive and can be treated with a chemical agent.

6. Documentation requirements

To support a claim for CPT 46900, the provider must document the following information:

• Identification of the anal lesions, such as condyloma, papilloma, molluscum contagiosum, or herpetic vesicle
• The specific chemical agent used for the destruction
• Date of the procedure
• Details of the procedure, including the application of the caustic agent and the destruction of the lesions
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 46900, ensure that the provider performs a simple chemical destruction of anal lesions using a caustic agent. There are other codes available for different methods of destruction, such as electrodesiccation, cryosurgery, laser surgery, and surgical excision. It is important to select the appropriate code based on the specific method used.

8. Historical information

CPT 46900 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider applies bichloracetic acid to a condyloma on the perianal skin, causing the lesion to be burned and destroyed.
2. A patient presents with a papilloma on the anus, and the provider uses dichloroacetic acid to destroy the lesion.
3. A provider applies a caustic agent to a molluscum contagiosum on the perianal skin, resulting in the destruction of the lesion.
4. A patient has a herpetic vesicle on the anus, and the provider uses a chemical agent to burn and remove the lesion.
5. A provider identifies multiple condylomas on the perianal skin and performs a chemical destruction of the lesions using a caustic agent.
6. A patient presents with papillomas on the anus, and the provider uses a chemical agent to destroy the lesions.
7. A provider applies bichloracetic acid to a molluscum contagiosum on the perianal skin, causing the lesion to be burned and removed.
8. A patient has herpetic vesicles on the anus, and the provider performs a chemical destruction of the lesions using a caustic agent.
9. A provider identifies a condyloma on the perianal skin and uses a chemical agent to burn and destroy the lesion.
10. A patient presents with a papilloma on the anus, and the provider performs a chemical destruction of the lesion using a caustic agent.