CPT® Code 46045

The CPT® Code 46045 refers to the procedure of incision and drainage of an intramural, intramuscular, or submucosal abscess located in the anal region, performed transanally and under anesthesia. An intramural abscess is defined as one that is situated within the substance of the anal wall, while an intramuscular abscess occurs within the muscle tissue of the anal sphincter or the levator ani muscles. A submucosal abscess, on the other hand, is found just beneath the mucosal layer of the anus, within the submucosal tissue. The procedure typically begins with a digital examination to accurately identify the location of the abscess. Once located, a radial or cross-shaped incision is made over the most prominent part of the abscess or the area exhibiting the greatest fluctuance. This incision allows for the excision of the edges to expose the abscess cavity, facilitating wide drainage. During the procedure, the abscess cavity is manually inspected, and any loculations, or pockets of pus, are broken up to ensure complete drainage. After the drainage is accomplished, the incisions may be left open to allow for continued drainage, packed with iodophor gauze for a duration of 24 hours, or a drain may be placed to assist in the management of the abscess.