# 45990 Exam Under Anesthesia ???



## hedmiston (Jul 29, 2015)

I have always been taught to bill CPT 45990 - EUA, an anoscopy and proctoscopy must be performed. The CPT guidelines state 45990 includes the following elements:
- External perineal exam  
- Digital rectal exam
- Pelvic exam (when performed)  
- Diagnostic anoscopy
- Diagnostic rigid proctoscopy

One physician said these scopes are hardly ever used in the OR, but they use a Hilferguson for the same thing. 

My thought is you have to perform all of the elements except the pelvic exam or the pelvic exam wouldn't be an option. Please post your opinions on this. What must be performed to bill an EUA?

Thank you in advance!


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## wjwalters1 (Oct 9, 2015)

*RE: EUA under anesthesia*

According to Super Coder not all elements must be performed but if they are not you would append modifier -52.
https://www.supercoder.com/coding-n...rgery-doesnt-necessarily-mean-no-code-article


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