CPT® Code 46705

1. Indications

The anoplasty procedure, coded as CPT® 46705, is indicated for the treatment of anal strictures in infants. These strictures may arise from various conditions, including:

• Congenital Anal Stricture: A structural abnormality present at birth, also referred to as anal stenosis.
• Acquired Anal Stricture: A condition resulting from scar tissue formation due to trauma, previous surgical procedures, or radiation therapy for cancers affecting the perianal region.

2. Procedure

The anoplasty procedure involves several critical steps to effectively address anal strictures in infants. The following outlines the procedural steps:

• Step 1: The procedure begins with the patient being placed under appropriate anesthesia to ensure comfort and safety during the surgery.
• Step 2: The surgeon makes an incision in the anal mucosa to access the underlying scar tissue. This incision is crucial for exposing the area that requires intervention.
• Step 3: Once the scar tissue is exposed, the surgeon carefully incises the scar tissue within the anal canal or anal sphincter. This step is essential for releasing the stricture and widening the anal canal, thereby restoring normal function.
• Step 4: After the stricture has been addressed, the surgeon proceeds to repair the overlying tissues. This is done in layers to ensure proper alignment and healing of the anal mucosa.
• Step 5: Finally, the surgical site is meticulously inspected for any bleeding or complications before concluding the procedure and ensuring the infant's safety during recovery.

3. Post-Procedure

Post-procedure care following anoplasty involves monitoring the infant for any signs of complications, such as infection or excessive bleeding. The recovery process typically includes managing pain and ensuring the infant is comfortable. Parents or caregivers will receive instructions on how to care for the surgical site, including keeping it clean and dry. Follow-up appointments are essential to assess healing and function, and to address any concerns that may arise during the recovery period. It is important to ensure that the infant is able to pass stool without difficulty, indicating that the procedure has been successful in alleviating the stricture.