Summary & Overview
CPT 46705: Anoplasty for Infant Anal Stricture
CPT code 46705 denotes an anoplasty performed to treat anal stricture in an infant, a focused pediatric surgical procedure that restores anal patency and function. This code is relevant nationally because it captures operative management of congenital or acquired anorectal narrowing in the pediatric population and is used in surgical, hospital, and ambulatory billing workflows. Accurate coding ensures appropriate classification of procedural complexity and site of service for reimbursement and quality reporting.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the procedure, common sites of service, and typical billing considerations tied to pediatric anorectal surgery. The publication also outlines what to expect in payer coverage patterns and billing benchmarks where available, highlights potential policy updates affecting surgical pediatric codes, and clarifies the clinical indications that commonly drive use of this code. Technical readers will gain insight into typical service settings, payer landscape, and the role of this code within pediatric surgical service lines.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, payer-specific rates, and related codes.
Billing Code Overview
CPT code 46705 describes an anoplasty performed to correct an anal stricture in an infant. This is a surgical procedure focused on restoring patency and function of the anus by releasing or reconstructing the narrowed segment.
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Typical service type: Pediatric surgical procedure (anorectal surgery)
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Typical site of service: Operating room or ambulatory surgical center, depending on clinical circumstances and anesthesia needs.
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Clinical & Coding Specifications
Clinical Context
An infant (typically neonate to 12 months) presents with symptoms of anorectal stricture such as difficulty passing stool, persistent constipation, painful defecation, and perianal irritation. Examination reveals a narrowed anal canal or stenosis often following prior anorectal surgery (e.g., repair of imperforate anus) or secondary to inflammatory or ischemic causes. The surgical team (pediatric surgeon or pediatric colorectal surgeon) evaluates the infant in preoperative clinic, obtains informed consent from the caregiver, reviews prior operative records and imaging if relevant, and coordinates anesthesia (pediatric general anesthesia) and perioperative pediatric nursing care. In the operating room under sterile conditions and appropriate anesthesia, the provider performs an anoplasty (46705) to excise scar tissue and reconstruct or widen the anal verge and distal canal to restore patency. Postoperative workflow includes recovery in PACU, pain management appropriate for age, stool regimen to avoid stricture recurrence, wound and diaper care education for caregivers, scheduled follow-up visits to assess healing and anal caliber, and documentation of operative findings, technique, and any immediate complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced service | Use when the anoplasty is partially performed or the full service is not completed as originally intended. |