2025 CPT code 46707
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Repair of anorectal fistula with a bioabsorbable plug (e.g., porcine small intestine submucosa [SIS]).
Modifiers may be applicable (e.g., 22 for increased procedural services, 59 for distinct procedural service).
Medical necessity must be established by documenting failed conservative treatments, persistent symptoms (e.g., drainage, pain, recurrent infection), and the appropriateness of using a bioabsorbable plug for the specific type and location of the fistula.
The surgeon performs a digital rectal exam, possibly anoscopy or sigmoidoscopy.After prepping and anesthetizing the patient, they insert the bioabsorbable plug into the fistula tract and secure it, often with sutures or staples.Post-operative observation may be required.
In simple words: The surgeon repairs an abnormal opening between the anus/rectum and the skin, called a fistula, using a special plug made of natural material. This plug helps the body close the opening and heal naturally.
This procedure involves the surgical repair of an anorectal fistula using a bioabsorbable plug, often derived from porcine small intestine submucosa (SIS).The plug is inserted into the fistula tract to close the abnormal connection between the anus/rectum and the skin.It acts as a scaffold for tissue growth and is eventually absorbed by the body.
Example 1: A patient with a recurrent anorectal fistula that has not responded to conservative treatment undergoes repair with an SIS plug., A patient with a complex anorectal fistula involving the sphincter muscles undergoes repair with a bioabsorbable plug to minimize the risk of incontinence. , A patient with Crohn's disease and a perianal fistula undergoes repair with a bioabsorbable plug.
Documentation should include the location and type of fistula, previous treatments, confirmation of the use of a bioabsorbable plug (e.g. SIS), method of securing the plug, and any complications.
** Coverage policies for this procedure vary among payers, and some consider the use of bioabsorbable plugs investigational.Pre-authorization may be required.It's important to confirm coverage with the payer before performing the procedure. As of December 1st, 2024, this information is current but may be subject to change.
- Revenue Code: P6C (MINOR PROCEDURES - OTHER)
- Specialties:Colorectal Surgery, General Surgery
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, Outpatient Hospital