tci General Surgery Coding Alert - 2019 Issue Q3

You Be the Coder: Distinguish 3 Anal Fistula Codes

Question: The op report describes the surgeon identifying an internal anal fistula opening, then cutting open the fistula tract from the anal sphincter to the external anus, cutting open the fistula, and scraping/flushing the tract before stitching sides to open the fistula. How should we code this? Tennessee Subscriber Answer: The code that most accurately represents the procedure you’ve described is 46280 (Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed). The surgeon described a fistula that extends from the sphincter muscle to the external anal canal, so this is...

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