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Official Description

Removal of Thiersch wire or suture, anal canal

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 46754 refers to the procedure for the removal of Thiersch wire or suture from the anal canal. This procedure is part of a Thiersch operation, which is commonly known as anal encirclement. The Thiersch operation is primarily indicated for patients suffering from rectal incontinence or rectal prolapse. During this surgical intervention, a thin band made of non-absorbable material, such as wire or suture, is strategically placed beneath the skin surrounding the anus. This band is then advanced to encircle the entire circumference of the anal area. Over time, the presence of this foreign material leads to the formation of a fibrous ring, which serves to support the anal canal, thereby preventing the prolapse of the rectum and mitigating issues related to incontinence. It is important to note that CPT® Code 46753 is designated for the initial placement of the wire or suture, while CPT® Code 46754 specifically pertains to the removal of this material.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 46754 is indicated for specific conditions related to the anal canal. The following are the primary indications for performing the removal of Thiersch wire or suture:

  • Rectal Incontinence This condition involves the involuntary loss of bowel control, leading to the unintentional passage of stool.
  • Rectal Prolapse This occurs when the rectum protrudes through the anus, which can cause discomfort and complications.

2. Procedure

The procedure for the removal of Thiersch wire or suture involves several key steps that ensure the safe and effective extraction of the material from the anal canal. Each step is crucial for minimizing patient discomfort and preventing complications.

  • Step 1: Preparation The patient is positioned appropriately, and the area around the anus is cleaned and sterilized to reduce the risk of infection. Local anesthesia may be administered to ensure the patient is comfortable during the procedure.
  • Step 2: Identification of the Wire or Suture The surgeon carefully examines the anal canal to locate the Thiersch wire or suture that was previously placed. This may involve the use of specialized instruments to visualize the area clearly.
  • Step 3: Removal of the Material Once the wire or suture is identified, the surgeon gently grasps it with forceps and carefully pulls it out of the anal canal. This step requires precision to avoid damaging surrounding tissues.
  • Step 4: Post-Removal Assessment After the wire or suture has been removed, the surgeon inspects the anal canal for any signs of irritation or injury. If necessary, additional measures may be taken to ensure proper healing.

3. Post-Procedure

Following the removal of the Thiersch wire or suture, the patient may be monitored for a short period to ensure there are no immediate complications. Post-procedure care typically includes instructions on maintaining hygiene in the anal area and monitoring for any signs of infection or unusual symptoms. Patients may be advised to avoid strenuous activities for a specified period to promote healing. Follow-up appointments may be scheduled to assess recovery and address any ongoing concerns related to rectal incontinence or prolapse.

Short Descr REMOVAL OF SUTURE FROM ANUS
Medium Descr RMVL THIERSCH WIRE/SUTURE ANAL CANAL
Long Descr Removal of Thiersch wire or suture, anal canal
Status Code Active Code
Global Days 010 - Minor Procedure
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) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - 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.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
GC This service has been performed in part by a resident under the direction of a teaching physician
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Pre-1990 Added Code added.
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