2025 CPT code 46706
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Repair of anal fistula with fibrin glue.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 59 for distinct procedural service, 22 for increased procedural services). Consult appropriate modifier guidelines.
Medical necessity is established when conservative treatment options have failed or are not suitable, and the patient presents with symptoms related to an anal fistula that significantly impacts their quality of life. The complexity of the fistula (location, depth, tract length) should be considered.Pre-operative assessment is crucial for appropriate patient selection.
The physician's responsibilities include patient preparation and anesthesia, positioning the patient in lithotomy position, inspecting and preparing the fistula site, mixing and injecting the fibrin glue via cannula, and post-procedure monitoring.The physician may also be responsible for follow-up care.
In simple words: The doctor fixes a small tunnel (fistula) near the anus by injecting a special glue that helps it heal. This avoids more complex surgery.
This CPT code describes the surgical repair of an anal fistula using fibrin glue.The procedure involves injecting fibrin glue into the fistula tract to promote healing. The process may include prepping the patient, placing them in a lithotomy position, inspecting the fistula, preparing the area, inserting a dual-chamber syringe containing fibrinogen and thrombin (mixed together) via a cannula into the fistula tract, completely filling the defect, withdrawing the cannula, and allowing the fistula to heal naturally.The anal canal, anus, rectum, and fibrin glue are key anatomical and procedural elements.
Example 1: A patient presents with a recurrent anal fistula that has failed to respond to conservative measures.The physician determines that fibrin glue injection is an appropriate treatment option given the patient's history and the location and complexity of the fistula. The procedure is performed as an outpatient., A patient presents with a newly diagnosed low transsphincteric anal fistula. The physician decides to treat the fistula with fibrin glue as a less invasive treatment option. The procedure is performed under local anesthesia in the office setting., A patient with Crohn's disease and a complex anal fistula is a candidate for fibrin glue injection, but the physician needs to carefully assess the risk and benefit, considering the underlying disease process and potential impact on healing.
Complete patient history including previous treatments for anal fistula,physical examination notes documenting fistula location, size, and tract characteristics;imaging studies (if performed); operative notes detailing the procedure (amount of fibrin glue used, location of injection, cannula size); post-operative notes documenting healing progress and any complications; consent form.
** Success rates vary widely depending on fistula complexity and patient factors.Fibrin glue injection may not be suitable for all patients with anal fistulas. Thorough patient selection and pre-operative assessment are essential.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- Payment Status: Active
- Modifier TC rule: No technical component (TC) modifier needed for this code.
- Specialties:Colorectal Surgery, General Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)