LCD Reference Article Billing and Coding Article

Billing and Coding: High Resolution Anoscopy

A59323

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Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
NOT AN LCD REFERENCE ARTICLE
This article is not in direct support of an LCD.

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General Information

Source Article ID
N/A
Article ID
A59323
Original ICD-9 Article ID
Not Applicable
Article Title
Billing and Coding: High Resolution Anoscopy
Article Type
Billing and Coding
Original Effective Date
01/12/2023
Revision Effective Date
12/12/2024
Revision Ending Date
N/A
Retirement Date
N/A

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Current Dental Terminology © 2023 American Dental Association. All rights reserved.

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CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e) prohibits Medicare payment for any claim which lacks the necessary information to process the claim

Article Guidance

Article Text

High-resolution anoscopy (HRA) is analogous to cervical colposcopy. During HRA, a lubricated anoscope is inserted into the anal canal. A cotton swab wrapped in gauze and soaked in 3-percent acetic acid is then inserted through the anoscope, and the anoscope is removed, leaving the gauze in place. The acetic acid gives dysplastic epithelium a white appearance. After 2 minutes, the gauze is removed and the anoscope reinserted. A high-resolution colposcope (magnification of 10x to 40x) is used to view the walls of the anus. A biopsy of suspicious tissue can be taken.

Anal squamous dysplasia describes a spectrum of diseases that ranges from low-grade squamous intraepithelial lesions (LSIL) to higher grade squamous lesions, or to invasive anal squamous cell carcinoma (SCC). Recent reports have shown a significant increase in squamous lesions in immunocompromised individuals and men who have sex with men (MSM). These lesions are associated with chronic infection with the human papillomavirus (HPV).

CPT® codes 46601 and 46607 should be used for patients with abnormalities on anoscopy, abnormalities in digital rectal examination, history of HPV-related anal disease or abnormalities in anorectal cytology.

Response To Comments

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Coding Information

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Revenue Codes

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Revision History Information

Revision History Date Revision History Number Revision History Explanation
12/12/2024 R2

Under Article Text revised the third paragraph to add the verbiage, “for” and remove the verbiage, “only in these circumstances:”. The last paragraph was deleted.

11/21/2024 R1

Under Article Text deleted the first sentence in the last paragraph.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
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Public Versions
Updated On Effective Dates Status
12/03/2024 12/12/2024 - N/A Currently in Effect You are here
11/13/2024 11/21/2024 - 12/11/2024 Superseded View
01/03/2023 01/12/2023 - 11/20/2024 Superseded View

Keywords

  • High Resolution Anoscopy
  • Anoscopy