CPT CODES

CPT Code 46230

CPT code 46230 is for the removal of anal tags, a procedure to excise excess skin growths around the anal area.

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What is CPT Code 46230

CPT code 46230 is for the surgical removal of anal tags, which are small, benign growths or excess skin that can occur around the anal area. This procedure typically involves excising these tags to alleviate discomfort, improve hygiene, or for cosmetic reasons.

Does CPT 46230 Need a Modifier?

For CPT code 46230, "Removal of anal tags," the following modifiers may be applicable:

1. Modifier 22 - Increased Procedural Services: Used when the work required to provide a service is substantially greater than typically required.

2. Modifier 50 - Bilateral Procedure: Used if the procedure is performed on both sides of the body.

3. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same surgical session.

4. Modifier 52 - Reduced Services: Used when a service or procedure is partially reduced or eliminated at the physician's discretion.

5. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.

6. Modifier 76 - Repeat Procedure or Service by Same Physician: Used when a procedure or service is repeated by the same physician or other qualified healthcare professional.

7. Modifier 77 - Repeat Procedure by Another Physician: Used when a procedure or service is repeated by another physician or other qualified healthcare professional.

8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician: Used for a related procedure during the postoperative period.

9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used for an unrelated procedure or service by the same physician during the postoperative period.

10. Modifier 99 - Multiple Modifiers: Used when two or more modifiers are necessary to describe the service.

Each of these modifiers serves a specific purpose and should be used according to the guidelines to ensure accurate billing and reimbursement.

CPT Code 46230 Medicare Reimbursement

CPT code 46230 is reimbursed by Medicare. The code is listed on the Medicare Physician Fee Schedule (MPFS), which indicates that it is a covered service. However, coverage and reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region. It's important to verify with your local MAC for any specific coverage guidelines or documentation requirements related to this procedure.

Are You Being Underpaid for 46230 CPT Code?

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