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An imperforate anus is a congenital condition characterized by the absence of a proper anal opening, which can manifest as either a complete lack of an anal orifice or the presence of a small, improperly positioned fistulous tract. The term "high imperforate anus" is considered outdated; however, it generally refers to a malformation that occurs above the levator ani muscles, which are critical components of the pelvic floor. In contemporary medical practice, anorectal malformations are classified based on their anatomical features rather than outdated terminology. The procedure described by CPT® Code 46730 involves a surgical repair of a high imperforate anus using either a perineal or sacroperineal approach. This technique includes the identification of the anorectal muscle complex through the use of a muscle-stimulating device, which aids in accurately locating the necessary anatomical structures. The surgical process entails making an incision in the perineum, either anterior or posterior to the anorectal muscles, and carefully dissecting to reach the presacral space. Once the rectal pouch is located, it is mobilized while ensuring complete separation from any attachments to the genitourinary tract. The procedure culminates in the creation of a functional anal opening by suturing the rectal mucosa to the skin, thereby establishing a new anal orifice.
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The procedure described by CPT® Code 46730 is indicated for the surgical repair of a high imperforate anus without fistula. This condition is typically diagnosed in newborns and may present with various symptoms, including the absence of a normal anal opening, abdominal distension, and failure to pass meconium within the first 24 hours of life. Surgical intervention is necessary to correct the anatomical defect and establish a functional anal passage.
The surgical procedure for CPT® Code 46730 involves several critical steps to ensure the successful repair of the high imperforate anus.
After the completion of the surgical repair, post-procedure care is essential for ensuring proper healing and function. Patients may require monitoring for any signs of complications, such as infection or issues with the newly created anal opening. Follow-up appointments will be necessary to assess the healing process and the functionality of the anal passage. Additionally, caregivers may need guidance on postoperative care, including dietary modifications and bowel management strategies to support recovery.
| Short Descr | CONSTRUCTION OF ABSENT ANUS | Medium Descr | RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR | Long Descr | Repair of high imperforate anus without fistula; perineal or sacroperineal approach | Status Code | Active Code | Global Days | 090 - Major Surgery | 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) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 96 - Other OR lower GI therapeutic procedures |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. |
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| Pre-1990 | Added | Code added. |
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