CPT® Code 46751

Sphincteroplasty, specifically coded as CPT® 46751, is a surgical procedure aimed at addressing anal or fecal incontinence in children. This condition arises from damage or weakening of the anal sphincters, which can be either the external or internal sphincter, or may result from rectal prolapse. Anal incontinence is characterized by the inability to retain stool within the rectum, leading to involuntary leakage. In adults, this issue is often due to traumatic injuries such as tears or lacerations, while in children, it is frequently linked to congenital anomalies present from birth. The procedure involves a meticulous surgical approach where the perineal area is first cleansed, followed by the administration of a local anesthetic and a vasoconstrictor to minimize bleeding at the surgical site. A curvilinear incision is then made parallel to the external sphincter, allowing the surgeon to dissect the anal mucosa away from any scar tissue and the underlying sphincter muscles. The dissection is carefully extended up to the levator ani muscle, and any scar tissue present is excised. To restore function, the muscle ends may be overlapped to decrease the anal diameter, and both the internal and external sphincters are repaired using sutures. Finally, the overlying mucosa and skin are also sutured to complete the procedure. It is important to note that CPT® 46751 is specifically designated for use in pediatric cases, while CPT® 46750 is the corresponding code for sphincteroplasty performed on adults.