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Wiki Perianal lesion

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tlm5506

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Free Soil, MI
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Hello.
I'm stuck on this one.
Physician performed a colonscopy and biopsied a lesion at the hepatic flexure and two lesions in the rectum. Then he performed an anorectal exam and did an incisional biopsy of a perianal lesion.
I am coding a 45380 for the colonscopy with biopsies and will code a 45990 for the anorectal exam. I am having difficulty finding a code for the perianal lesion biopsy.
 
I did look at 46606, but he took the biopsy during the anorectal exam. The 46606 is under Endoscopy. That's why I'm stuck.
 
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