In simple words: This procedure involves injecting a medicine into the muscle around the anus to relax it and relieve pain from a tear or crack in the anal lining (anal fissure).

Chemodenervation of the internal anal sphincter involves injecting a pharmacological agent, such as botulinum toxin or atropine, into the internal anal sphincter muscle. This procedure aims to interrupt nerve signals, causing muscle relaxation and alleviating spasms associated with conditions like anal fissures. The specific substance injected should be documented.

Example 1: A patient presents with a chronic anal fissure unresponsive to conservative management.The physician performs chemodenervation of the internal anal sphincter using botulinum toxin A, injecting 20 units into the affected area., A patient with an acute anal fissure experiencing significant pain undergoes chemodenervation using botulinum toxin B, with the injection site carefully documented and the amount of toxin administered recorded., A patient with recurrent anal fissures after previous unsuccessful treatments has chemodenervation with a different agent, such as atropine, where dosage and injection technique are carefully documented. Post-procedure pain management and follow-up are planned.

* Pre-procedure diagnosis of anal fissure.* Type and amount of chemodenervating agent used.* Injection site(s) and technique.* Documentation of informed consent.* Post-procedure assessment, including pain management and follow-up plans.

** Always refer to the most current CPT codebook and coding guidelines for accurate billing practices.Documentation of the specific agent and technique used is crucial for appropriate reimbursement.