Summary & Overview
CPT 46754: Removal of Thiersch Suture or Wire from Anal Canal
CPT code 46754 represents the procedural removal of a suture or wire from the anal canal that was placed during a Thiersch procedure to manage rectal incontinence or prolapse. This targeted procedure is typically performed in outpatient surgical settings, ambulatory surgery centers, or hospital outpatient departments and is relevant to colorectal surgery and pelvic floor specialty care. Nationally, the code matters as part of the care pathway for patients with prior Thiersch repairs who require device removal for complications, failure, or planned revision.
Key payers in the scope of coverage and reimbursement discussion include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the service, an outline of common settings where the procedure is performed, and the payer landscape that commonly covers such services. The analysis provides benchmarks for utilization and reimbursement patterns where available, notes on coding practice and documentation expectations, and pointers to related procedural coding to aid billing and claims submission.
Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 46754 describes the removal of a suture or wire from the anal canal that was previously placed as part of a Thiersch procedure. This service involves extracting the material originally implanted to treat rectal incontinence or rectal prolapse.
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Service type: Procedural removal of implanted suture or wire from the anal canal
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Typical site of service: Outpatient surgical suite, ambulatory surgery center, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of rectal prolapse underwent a Thiersch procedure (placement of an encircling anal suture or wire) six months prior. The patient presents to the outpatient colorectal clinic for removal of the Thiersch suture due to recurrent local pain, erosion of the suture through perianal skin, or resolution of prolapse with need to discontinue the foreign material. The provider performs a brief focused history and focused exam, confirms indication for removal, counsels on risks, obtains informed consent, and arranges minor procedure room or office-based removal. The procedure typically involves local anesthesia and direct visualization of the anal canal, removal of the suture or wire, inspection for bleeding or residual damage, simple hemostasis if needed, and wound care instructions. Follow-up is arranged to assess wound healing and continence status. Typical site of service is an outpatient clinic procedure room, ambulatory surgery center, or hospital outpatient department depending on patient comorbidity and payer requirements. Service type: minor surgical procedure — removal of implanted anal suture/wire following Thiersch procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; not typically reported — use payer-specific guidance if required |
| 11 | Primary procedure | Use when this service is the primary procedure of the encounter |