CPT® Code 46940

Curettage or cautery of an anal fissure, including dilation of the anal sphincter, is a surgical procedure performed as a separate intervention. An anal fissure is defined as a painful tear or crack in the mucous membrane lining the anus, which can lead to significant discomfort and complications if not treated. In cases where the fissures become chronic, they may cause a narrowing or stricture of the anal sphincter, necessitating dilation to alleviate symptoms and restore normal function. The treatment involves curettage, a technique that entails scraping the fissure to remove damaged tissue and expose the healthy underlying mucosa, promoting healing. Following curettage, the fissure may be treated with chemical cautery, which utilizes agents such as silver nitrate or phenol in glycerine, or electrocautery, which applies heat through a high-frequency current delivered via a metal probe or needle. If a stricture is identified during the procedure, dilation is performed using a bougie, a flexible cylindrical instrument designed to stretch the narrowed area. This procedure is coded as CPT® Code 46940 for the initial treatment, while subsequent procedures are coded as CPT® Code 46942.