CPT® Code 46735

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 opening or the presence of a small, improperly positioned fistulous tract. The term "high imperforate anus" is considered outdated; however, it generally refers to a type of malformation that occurs above the levator ani muscles, which are critical components of the pelvic floor. This condition falls under the broader category of anorectal malformations, which are now classified based on specific anatomical features rather than solely on their location. The surgical procedure associated with CPT® Code 46735 involves a complex repair of a high imperforate anus using both transabdominal and sacroperineal approaches. This dual approach allows for comprehensive access to the rectal pouch, facilitating its mobilization and proper connection to the anorectal muscle complex. The procedure is designed to create a functional anal opening, ensuring that the rectum is adequately separated from any surrounding structures, particularly the genitourinary tract, to prevent complications and promote optimal recovery.