How To Use CPT Code 46712

CPT 46712 describes the repair of an ileoanal pouch fistula or sinus using a combined transperineal and transabdominal approach. 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 46712?

CPT 46712 can be used to describe the repair of an ileoanal pouch fistula or sinus using a combined transperineal and transabdominal approach. This code is used when the provider performs a procedure to repair a drainage tract or fistula that connects an ileoanal pouch to the perineal area or vagina. The repair is done by advancing the pouch through the perineum and abdomen.

2. Official Description

The official description of CPT code 46712 is: ‘Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined transperineal and transabdominal approach.’

3. Procedure

1. The provider begins the procedure by preparing and anesthetizing the patient.
2. They then repair the drainage tract or fistula that connects the ileoanal pouch to the perineal area or vagina.
3. The repair is performed through a combined transperineal and transabdominal approach.
4. The provider dissects the tract from its external origin to its origin at the ileoanal pouch.
5. They repair any damage found to the pouch using a pouch advancement technique.
6. The provider closes the defect by making an incision in the lower abdominal wall to gain internal access to the ileoanal pouch.

4. Qualifying circumstances

Patients eligible to receive CPT 46712 services are those who have an ileoanal pouch fistula or sinus that requires repair. This condition typically occurs in patients who have had their large intestine surgically removed due to diseases like ulcerative colitis, Crohn’s disease, colon cancer, or injury. The repair is performed using a combined transperineal and transabdominal approach.

5. When to use CPT code 46712

CPT code 46712 should be used when the provider performs a repair of an ileoanal pouch fistula or sinus using a combined transperineal and transabdominal approach. This code should be used for each instance of the procedure performed.

6. Documentation requirements

To support a claim for CPT 46712, the provider must document the following information:

• Patient’s diagnosis of an ileoanal pouch fistula or sinus
• Description of the repair procedure performed
• Date of the procedure
• Start and end time 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 46712, ensure that the repair is performed using a combined transperineal and transabdominal approach. Follow the appropriate coding guidelines and modifiers as required by the payer. It is important to review the payer’s specific policies and guidelines to ensure accurate billing and reimbursement.

8. Historical information

CPT 46712 was added to the Current Procedural Terminology system on January 1, 2006. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider repairs an ileoanal pouch fistula by advancing the pouch through the perineum and abdomen using a combined transperineal and transabdominal approach.
2. A patient with ulcerative colitis undergoes a repair procedure for an ileoanal pouch sinus that connects to the perineal area.
3. A provider performs a repair of an ileoanal pouch fistula that erodes into the vagina using a combined transperineal and transabdominal approach.
4. An individual who had their large intestine surgically removed due to Crohn’s disease undergoes a repair of an ileoanal pouch sinus through a combined transperineal and transabdominal approach.
5. A provider repairs a drainage tract from an ileoanal pouch to the perineal area in a patient who previously had colon cancer.
6. A repair procedure is performed on an ileoanal pouch fistula that erodes into the perineal area using a combined transperineal and transabdominal approach.
7. A patient with an injury-related ileoanal pouch sinus undergoes a repair procedure through a combined transperineal and transabdominal approach.
8. A provider repairs an ileoanal pouch fistula that connects to the vagina using a combined transperineal and transabdominal approach.
9. An individual who had their large intestine surgically removed due to ulcerative colitis undergoes a repair of an ileoanal pouch sinus through a combined transperineal and transabdominal approach.
10. A repair procedure is performed on an ileoanal pouch fistula that erodes into the perineal area in a patient with a history of Crohn’s disease.