CPT® Code 46604

Anoscopy with dilation is a medical procedure aimed at treating strictures of the anus, which are narrowings that can occur due to various factors such as previous surgeries, radiation therapy, or inflammatory diseases. During this procedure, the anus is first visually inspected, and a digital rectal examination may be performed to assess the condition further. The process begins with the insertion of an obturator into the anoscope, which is then carefully introduced into the anus. The anoscope is advanced toward the stricture using a twisting motion while the patient is instructed to bear down, facilitating the passage of the instrument. Once the anoscope reaches the stricture, the obturator is removed, and an eyepiece is attached to allow for direct visualization. A guidewire is then advanced through the anoscope to a location just proximal to the stricture, ensuring precise placement. Following this, a balloon catheter is introduced over the guidewire and positioned within the stricture. The balloon is inflated to dilate the narrowed area and is held in place for a brief period before being deflated and removed. Alternatively, a bougie, which is a flexible cylindrical instrument, may be utilized to stretch the stricture by passing it through the narrowed passage. After the dilation process, the area is re-examined using the anoscope to confirm the success of the dilation and to check for any potential injuries to the anal tissue that may have occurred during the procedure.