Wiki Help!!!-Does anyone know

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Does anyone know how to code for this:

Rectal examination under anesthesia with multiple punch biopsies of the anal margin.

Report states: Next, digital rectal examination was performed. It did appear that the lesion extends to the verge of the lower anal canal between 10 o'clock and 2 o'clock.

Next, multiple punch biopsies were taken throughout the lesion. Following this, adequate hemostasis was maintained. There was no other pathology identified during the procedure. The patient tolerated the procedure well.

I am leaning toward 45990 for the rectal exam, but no idea on the rest. Thanks in advance for your help!
 
45990 Rectal exam under anesthesia and 45100 Biopsy of anorectal wall, anal approach are bundled per CCI edits, so I would use 45100, as it has a higher RVU.

Hope this helps!
 
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