High Resolution Anoscopy (HRA) also known as colposcopy of the anal canal is a procedure used in the treatment and surveillance of anal dysplasia and the prevention of anal cancer. It is performed on individuals with an abnormal anal cytology or anal Pap test. Anal Pap tests are obtained on individuals who are at risk for genital or anal human papillomavirus (HPV) infections, even in the absence of signs or symptoms of infection.
HRA may be considered medically necessary for ANY ONE of the following conditions:
- Abnormal anal physical findings (e.g., anogenital warts, hypo-pigmented or hyper-pigmented plaques/lesions, lesions that bleed, high-grade suspicious intraepithelial lesion or any other lesion of uncertain etiology) or
- Anal dysplasia found in cytology/biopsy or
- For biopsy and ablation of high-grade anal intraepithelial neoplasia.
HRA for all other indications is considered experimental/investigational and therefore, non-covered due to lack of scientific evidence in the published peer reviewed literature.