# Perianal lesion removal code



## Nancy Grisanti

A patient had an excision of a malignant lesion of the perianal area.  Our coding team has a disagreement on which code to use.  One coder suggested 11623 and the other would like to use an unlisted code such as 46999.  Is a perianal area considered part of "genitalia"?


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## surgonc87

Per concept, I would agree with 11623 with repair, but depending on extent of resection and repair, if no codes describes in the digestive system section, then an unlisted code would do.


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## Nancy Grisanti

Thanks, I guess the real info that I need is more anatomical, is the perianal region considered part of the genitalia?


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## surgonc87

Yes it is, and whats funny is that I am working on the same case right now.

radical resection 5 cm mass right perianal space juxtaposed to the external sphincters.

I will be using 46999 with fee of $1585 mocking fee for 45171 because of extent of removal, and this was a recurrent melanoma


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## FTessaBartels

*46922*

Did you consider CPT 46922 ... surgical excision of anal lesions

F Tessa Bartels, CPC, CEMC


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## surgonc87

FTessaBartels said:


> Did you consider CPT 46922 ... surgical excision of anal lesions
> 
> F Tessa Bartels, CPC, CEMC




For my cases, they were more extensive then what the code describes, considering the fee as well...But 46922 is a good code too!


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## kristiford

46922 is "destruction". This would not be correct in this case.
You should definitely use the 11400-11440 codes.


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## FTessaBartels

*46922*



kristi.ford@dayton.miamijacobs.edu said:


> 46922 is "destruction". This would not be correct in this case.
> You should definitely use the 11400-11440 codes.



Please read the code description AFTER the semi-colon
46922 - Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; *surgical excision *

This code is definitely for excision of such lesions.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## Lujanwj

Perianal, to me, suggests that the lesion is not on the anus so 46*** series would not be appropriate.  If the lesion is integumentary, look at 11623 plus inter/complex closure.  If soft tissue use 27059.  If the anus is involved theses codes will not work and the other suggestions are more appropriate.  Just be sure the of the anus' involvement in the procedure.


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