CPT® Code 46020

An anal seton is a medical device used in the treatment of anal fistulas, which are abnormal connections or tunnels that form between the anal canal and the skin surrounding the anus. These fistulas often develop as a complication of a rectal abscess, where an infection leads to the formation of a pus-filled cavity that can drain into the anal canal. The placement of a seton involves inserting a length of non-absorbable suture material into the fistula tract to facilitate drainage, promote fibrosis, or gradually cut through the fistula for healing. The procedure is performed by identifying the fistula tract, inserting the suture material through the external opening, and passing it through the internal opening before pulling it back out of the anal canal. Depending on the intended purpose, the seton may be left loose for drainage or tied into a loop to apply gradual pressure, which helps in the healing process by cutting through the fistula over time. This procedure is coded as CPT® Code 46020, while the removal of the seton is coded as CPT® Code 46030.