CPT® Code 46715

An imperforate anus is a congenital condition characterized by the absence of a proper anal opening, which can manifest in various forms, including a small, misplaced fistulous tract. The term "low imperforate anus" is considered outdated; however, it typically refers to a malformation occurring at or below the levator ani muscles. In current medical practice, anorectal malformations are classified based on their anatomical features. An anoperineal fistula, which can occur in both males and females, indicates that while the anus is closed, there exists an opening in the perineal body. In males, this may present as a fistula extending into the scrotum, potentially leading to the presence of mucus or meconium in the scrotal tissues. In females, an anovestibular fistula may be identified as a small opening located in the posterior vestibule of the vagina. The procedure described by CPT® Code 46715 involves the surgical repair of a low imperforate anus with an anoperineal fistula through a technique known as the cut-back procedure. This surgical intervention aims to create a functional anal opening by repositioning the fistula within the external anal sphincter, thereby facilitating a larger outlet for stool passage and preventing complications such as bowel obstruction and colon hypertrophy.