CPT Code 46744 | Description & Clinical Information

CPT 46744 describes a surgical procedure in which the provider utilizes a sacroperineal approach to repair a female anorectal and vaginal defect or malformation, including any injury to the urethral wall, in the context of a cloacal anomaly.

Official Description

The CPT book defines CPT code 46744 as: “Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach”.

Billing Guidelines

Use CPT code 46744 without modifier 63.

Clinical Information

The procedure describes by CPT code 46744 is a surgical intervention used to treat severe cases of exstrophy-epispadias complex, a rare congenital abnormality that affects the urinary and genital systems. This highly complex procedure involves separating, excising, and re-positioning the bladder, urethra, and vagina to restore their proper functions and locations.

In order for the procedure to take place, the patient must be appropriately prepped and anesthetized. Once ready, the provider will place the patient in the lithotomy position and make a small incision in the perineum to gain access to the affected area.

The first step of the procedure is to excise the bladder, urethra, and vagina free of each other. If the bladder is swollen, it must be decompressed before continuing. This separation of the organs is necessary to properly reposition them and restore proper function.

Next, the provider places the opening of the vagina and the urethra in their correct positions. This step is crucial in restoring urinary continence and proper sexual function. It is often a delicate procedure that requires precise surgical skill.

In some cases, the provider may need to form a new rectum from muscle posterior to the rectum. This is an essential part of the procedure as it ensures proper bowel function and prevents fecal incontinence.

Finally, the provider will close the incision with sutures. After the surgery, the patient will need to stay in the hospital for several days to monitor their progress and ensure that no complications arise.

This complex surgical intervention requires a highly trained and specialized team of healthcare professionals. The medical team must work together to ensure that the patient receives the best possible care before, during, and after the procedure.

Although this procedure is highly specialized and not commonly performed, it is an essential treatment option for those suffering from exstrophy-epispadias complex. The procedure has helped many patients regain proper urinary and sexual function and improve their overall quality of life.

Return to all the CPT codes for repair procedures on the anus.

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