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The procedure described by CPT® Code 46706 involves the repair of an anal fistula using fibrin glue, a biocompatible adhesive that promotes healing. An anal fistula is an abnormal connection between the anal canal and the skin surrounding the anus, often resulting from an infection or abscess. The procedure begins with the preparation and draping of the perineum, ensuring a sterile environment. A digital rectal exam is performed to assess the condition and locate the fistula accurately. An anoscope, a tubular instrument, is then utilized to visualize the anal canal and identify the specific site of the fistula. Following this, a probe is introduced into the internal opening of the fistula, allowing the clinician to trace the fistulous tract to its external opening. To facilitate the repair, a curette is employed to remove any granulation tissue that may obstruct the healing process within the fistula tract. Finally, a flexible catheter is inserted at the internal opening, and fibrin glue is injected to fill the entire fistulous tract, effectively sealing it and promoting closure. This minimally invasive technique aims to reduce recovery time and complications associated with traditional surgical methods for fistula repair.
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The procedure for the repair of an anal fistula with fibrin glue is indicated for patients presenting with the following conditions:
The procedure for repairing an anal fistula with fibrin glue involves several key steps that ensure effective treatment.
After the procedure, patients are typically monitored for any immediate complications. Post-procedure care may include instructions on maintaining hygiene in the anal area to prevent infection and promote healing. Patients may also be advised on pain management strategies, as some discomfort is expected following the procedure. Follow-up appointments are essential to assess the healing process and ensure that the fistula has closed properly. Any signs of infection or recurrence should be reported to the healthcare provider promptly.
| Short Descr | REPR OF ANAL FISTULA W/GLUE | Medium Descr | REPAIR ANAL FISTULA W/FIBRIN GLUE | Long Descr | Repair of anal fistula with fibrin glue | Status Code | Active Code | Global Days | 010 - Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 96 - Other OR lower GI therapeutic procedures |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2003-01-01 | Added | First appearance in code book in 2003. |
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