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The CPT® Code 46744 refers to the surgical procedure known as the repair of a cloacal anomaly through anorectovaginoplasty and urethroplasty, utilizing a sacroperineal approach. Cloacal anomalies are congenital defects that occur exclusively in females, characterized by the abnormal merging of the rectum, vagina, and urethra into a single common channel. This condition necessitates surgical intervention to create separate functional openings for the rectum, vagina, and urethra. The specific surgical approach and repair technique employed depend on the precise nature of the cloacal anomaly and the anatomical configuration of the merging structures. In the case of a low cloacal anomaly, the sacroperineal approach is utilized, which involves making an incision in the posterior aspect of the perineum. This allows for dissection to the presacral space, where the rectal pouch can be identified and mobilized. The procedure aims to restore normal anatomy and function by carefully separating and reconstructing the affected structures, ensuring that the patient can achieve proper bowel and urinary function postoperatively.
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The procedure coded as CPT® 46744 is indicated for the surgical repair of cloacal anomalies in female patients. These anomalies are characterized by the abnormal fusion of the rectum, vagina, and urethra, leading to a single common channel. The specific indications for this procedure include:
The surgical procedure for CPT® 46744 involves several critical steps, executed in a systematic manner to ensure successful repair of the cloacal anomaly:
Post-procedure care following the repair of a cloacal anomaly via CPT® 46744 involves monitoring the patient for any complications and ensuring proper healing of the surgical sites. Patients may require follow-up visits to assess the functionality of the reconstructed openings and to manage any postoperative discomfort. It is essential to provide appropriate wound care instructions and to monitor for signs of infection or other complications. The expected recovery period may vary based on the individual patient's condition and the extent of the surgical repair performed.
| Short Descr | REPAIR OF CLOACAL ANOMALY | Medium Descr | RPR CLOACAL ANOMALY SACROPERINEAL | Long Descr | Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, 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 | 132 - Other OR therapeutic procedures, female organs |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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. | 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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| 1994-01-01 | Added | First appearance in code book in 1994. |
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