Botox injection - coding a procedure

dowero

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I need some advise on coding a procedure. My doctor had done a Rectal examination under anesthesia with intrasphincteri injection of Botox. How should I code this? Should I just code it as a Anorectal exam requiring anesthesia (45990) and add a 22 modifier to cover the botox injection or should I use unlisted (45999) for the whole procedure? No scope was used on this procedure.

Thanks,
 
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