Health data standards and systems

Please advise the correct code for debridement of anal fissure / fistula.

Is it correct to follow the Index pathway below to assign destruction of other lesion or tissue of anus?

Destruction (ablation) (cauterisation) (coagulation) (cryotherapy) (diathermy) (HIFUS) (irreversible electroporation) (laser) (microwave) (radiofrequency) (thermotherapy)
-lesion (tissue) (tumour) - see also Destruction/by siteanus (open)

90315-01 [933] Excision of other lesion or tissue of anus

Anorectal myectomy
Destruction of lesion or tissue of anus
Excision of anal:
- fissure
- fistula NOS

Excludes: excision of anal fistula involving sphincter mechanism (32159-00, 32159-02, 32162-00, 32162-02 [937])

VICC referred this query to ACCD who provided the following response:

Debridement of an anal fistula/fissure is performed in conjunction with interventions at the same site (eg fistulotomy, lateral internal sphincterotomy, insertion of seton). Therefore, an ACHI code is not assigned for the debridement component, as per the guidelines in ACS 0016 General procedure guidelines which states:

Do not code procedures which are individual components of another procedure. These components would usually be considered a routine or inherent part of the more significant procedure being performed.

Note: ACCD advised VICC that this query would not be published in CLIP. Therefore VICC has published the query in accordance with the Committee's business rule to publish queries referred to ACCD that ACCD does not publish.