Billing code
P046A — Repair Of Fourth Degree Tear Or Episiotomy Extension, Must Include Repair Of Rectal Mucosa, Perianal Sphincter And Perineum
Fourth-degree tear repair
Bill P046 for repair of a fourth-degree tear or episiotomy extension, including the rectal mucosa, perianal sphincter and perineum.
Watch for: Claims from physicians who aren't obstetrics and gynaecology specialists go to manual review; without rectal mucosa repair, bill P045.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $200.00 | $0.00 | $95.76 | $95.76 |
- Code
- P046A
- Description
- Repair Of Fourth Degree Tear Or Episiotomy Extension, Must Include Repair Of Rectal Mucosa, Perianal Sphincter And Perineum
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2026
- Termination date
- No end date
Explanation
Updated October 26, 2026
Repair of a fourth-degree tear or episiotomy extension, including the rectal mucosa, perianal sphincter and perineum.
What it covers
P046 is the repair of a fourth-degree tear or episiotomy extension. It must include repair of the rectal mucosa, the perianal sphincter and the perineum (K8). A repair of the sphincter and perineum without the rectal mucosa is P045.
It is a # service: the fee does not include hospital-funded premises, equipment and staff (K1).
Billing rules
- Claims for P046 from a physician whose specialty isn't Obstetrics and Gynaecology (20) must be submitted for manual review (K8).
- Repair of a tear or episiotomy extension that doesn't reach the perianal sphincter (first or second degree) is included in P006 and P020 and is not P045 or P046 (K6 commentary; K8, note 1).
- Repair of the superficial transverse perineal muscle counts as a second-degree repair, not P046 (K8, note 2).
- Anaesthesia is listed at 6 basic units, billed with suffix C (K8; K3, note 16).
- The Surgical Preamble applies to obstetric codes (K2, rule 5).
Often billed with
- P006 or P020, the vaginal delivery (K6).
Related codes: P045, P006, P020, P036, P039, Z774
Source: Schedule of Benefits (July 1, 2026), Obstetrics, Labour - Delivery, page K8.
APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing