# Anal Fistulotomy



## codedog

I am trying to see which code  fits this procedure . Booking was for 46200-fissurectomy but I dont   see where the sphincterotomy comes in , looking at 46270 or 46275 but not sure 
any suggestions? 


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   lPROCEDURE IN DETAIL:  After appropriate informed consent was signed, the patient was taken to the operating room.  He was transferred to the operating table and underwent general anesthesia with endotracheal intubation.  He was placed in a prone position.  The area was prepped and draped in normal fashion.  The patient had previous anal fistulotomy x2.  The probe was then placed in and this was noted to go deep all the way high into the rectum and the upper part of the rectum.  This was excised down as far as I could.  The anal fistula was then noted and probe was then placed and noted to go high in the rectum.  At least 10 cm up, this was opened up as best we could without damaging the muscles.  I was very careful not to damage any of the muscles as much of the fistula could be retracted.  The _____(00:54) skin was retracted and the connections were removed.  This was carefully rongeured out and Bovied out as best we could without damaging any of the muscles.  Again, great care was taken not to damage any of the sphincter muscles.  The specimen was sent to pathology for permanent section.  The skin was then gently closed with 2-0 nylon.  Sterile dressing was placed.  The patient tolerated the procedure and transferred to the recovery room in stable condition.


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## purplescarf23

I would be inclined to go with 46270.  Not much dictation but that's what you have to go one  

Kelsey, CPC


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## colorectal surgeon

You need to ask the doctor.  Too little info to tell.


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