How To Use CPT Code 46270

CPT 46270 describes the surgical treatment of an anal fistula, specifically the subcutaneous type. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 46270?

CPT 46270 is used to describe the surgical treatment of an anal fistula, specifically the subcutaneous type. This procedure involves making an incision over the skin where the fistula is present and either removing or incising the fistula tract for treatment.

2. Official Description

The official description of CPT code 46270 is: ‘Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous.’

3. Procedure

1. The provider begins by appropriately prepping and anesthetizing the patient.
2. They then retract the anal opening to confirm the exact location of the fistula.
3. An incision is made over the fistula through the skin and subcutaneous tissue to reach the fistula.
4. The provider either incises around the fistula to separate it from nearby tissues and removes the fistula or incises the fistula for draining.
5. The area is irrigated with antibiotics to prevent infection.
6. The provider repairs the skin incision with sutures or leaves the wound open for drainage and self-healing.

4. Qualifying circumstances

CPT 46270 is used for the surgical treatment of an anal fistula, specifically the subcutaneous type. An anal fistula is an abnormal passageway between structures, such as vessels, organs, or skin and organs. The procedure is performed when the patient has a subcutaneous anal fistula that requires surgical intervention.

5. When to use CPT code 46270

CPT code 46270 should be used when a provider performs a surgical treatment for a subcutaneous anal fistula. It is important to accurately document the type of fistula and the specific procedure performed to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 46270, the provider must document the following information:

• Type of anal fistula being treated
• Description of the surgical procedure performed
• Date of the procedure
• Any additional details or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 46270, ensure that the procedure performed matches the description of the code. It is important to accurately document the details of the procedure to support the claim. CPT code 46270 should not be reported with other codes unless additional procedures were performed during the same session that are separately reportable.

8. Historical information

CPT 46270 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient undergoes a surgical treatment for a subcutaneous anal fistula, with the provider making an incision and removing the fistula.
2. A provider performs a surgical treatment for a subcutaneous anal fistula, incising the fistula for draining and leaving the wound open for self-healing.
3. During a surgical procedure, the provider incises around a subcutaneous anal fistula to separate it from nearby tissues and removes the fistula.
4. A patient with a subcutaneous anal fistula undergoes a surgical treatment, with the provider repairing the skin incision with sutures.
5. A provider performs a surgical treatment for a subcutaneous anal fistula, irrigating the area with antibiotics to prevent infection.
6. During a surgical procedure, the provider incises a subcutaneous anal fistula for draining and leaves the wound open for drainage and self-healing.
7. A patient undergoes a surgical treatment for a subcutaneous anal fistula, with the provider making an incision and removing the fistula.
8. A provider performs a surgical treatment for a subcutaneous anal fistula, incising the fistula for draining and leaving the wound open for self-healing.
9. During a surgical procedure, the provider incises around a subcutaneous anal fistula to separate it from nearby tissues and removes the fistula.
10. A patient with a subcutaneous anal fistula undergoes a surgical treatment, with the provider repairing the skin incision with sutures.