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CPT 46070: Incision of Congenital Anal Membrane in Infant
CPT code 46070 denotes surgical incision of a congenital membrane at the anal opening in an infant, a focused pediatric procedure to restore anal patency. Nationally, this code is used in pediatric surgical cases addressing congenital anorectal membrane or imperforate membrane presentations that require minor operative management. Accurate coding supports appropriate clinical documentation, billing consistency, and claims adjudication for a rare but important neonatal surgical intervention.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, coding context, and what to expect when this service is billed across major payers. The publication summarizes typical sites of service, common billing considerations, and benchmarking pointers where available.
This summary provides clinical context for coding, outlines the service setting, and highlights payer coverage scope. It also indicates where input data are incomplete: when specific payer policies, modifiers, associated taxonomies, or ICD-10 diagnosis pairings are not provided, the notation "Data not available in the input." is used. The intent is to give a national audience clear, actionable information about CPT code 46070 without making practice recommendations.
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Billing Code Overview
CPT code 46070 describes an operative procedure to incise a congenital membrane at the anal opening of an infant. This procedure addresses a congenital obstruction of the anal canal caused by a persistent membrane that prevents normal patency.
Service type: Surgical procedure — congenital anorectal membrane incision
Typical site of service: Inpatient or outpatient pediatric surgical setting
Data not available in the input.