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This has a lower success rate than a fistulotomy, but avoids the need to cut the anal sphincter muscles. An anal fistula is defined as a small tunnel with an internal opening in the anal canal and an external opening in the skin near the anus. Anal fistulas form when an anal abscess, thats drained, doesnt heal completely. Different types of anal fistulas are classified by their location. 46288 closure of anal fistula with rectal advancement flap treatment algorithm for anal fistulae fistulae fistulotomy success rate 99 in correctly sl tdfitl seton placement 2 or 3 in the same track or tracks selected fistulae control diarrhea fiber 30gmsday and probiotics wait one month or until diarrhea controlled surgery success 67. A fistulotomy is a procedure that may be done to remove a fistula. Learn more about what to expect during and after this procedure. Cpt 46221 is for rubber band ligation and cpt 4694546 are using other than rubber band ligation. Codes 4694546 have been relocated from the suture section since it does not involve sutures. These codes, along with cpt 46250, 4620, are revised to note the number of column. Cpt code information is available to subscribers and includes the cpt code number, short description, long description, guidelines and more. Aha coding clinic for hcpcs - current archives aha coding clinic for icd-10-cm and icd-10-pcs - current archives ama cpt assistant - current archives ama cpt knowledge base qa bc advantage articles, webinars, 20 ceus - current archives decisionhealth pink sheets, part b news - current archives find-a-code articles. fistulotomy dividing the interal anal sphincter laura posted wed 31st of july, 2013 135510 pm what cpt codes would be appropriate for anal fistula involving a posterior anal fissure, with fistulotomy dividing the interal anal aphincter muscle to that level, therefore no left partial lateral interal sphincterotomy was performed. Pre-operative preparation for a anal fistulotomy procedure there is some important information about the pre-operative preparation for this procedure. Read about anorectal pre-operative preparation procedure a fistulotomy is the standard technique of managing an anal fistula.