# anal biopsies



## sundaey (Mar 28, 2008)

hello party people in the place to be......

I have 2 colorectal surgeons, and lately they have had many patients present w/ anal cancer and my surgeons have dictated that they have biopsied the tumor w/out the use of an anoscope. Several of the patients have had tumors that come out of the anus, and that's where the biopsies have been taken from.

Since there aren't any codes for an EUA w/ biopsy, and alot of payors will not pay for an unlisted code, what would you suggest?

also, a few of the female pt's have an rectovaginal fistula that have had tumors present and those have been biopsied, again, w/out the use of any scopes.

HELP! 

much mahalos.


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## acbarnes (Apr 10, 2008)

what about 45100 (Bx anorectal wall), anal approach?


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## sundaey (May 1, 2008)

I looked at that code too, but it isn't the wall. The mass is actually protruding out, to where it was mistaken as a hemorrhoid. That's where the bx was taken from.


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## acbarnes (May 23, 2008)

just a thought....

Even through the bx is not necessarily taking place inside the anus/rectum, the tumor is still made up of the anorectal wall so you are still bx the anorectal wall, it is just prolapsing outside the anus. The code is still valid. 

The code is only valid if the tumor is an anorectal tumor. 

What did you end up doing? We do some of these also and I would be interested to know what other people are coding.


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## sundaey (May 27, 2008)

I went back and asked my doc if she was using an anoscope at all for these procedures, and she said yes, so that helped tremendously! I used the 46606 code for those. 

Thanks for all of the suggestions!


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