CPT code 45990 denotes a diagnostic anorectal examination performed with the patient under anesthesia, potentially including immediate minor therapeutic maneuvers if clinically indicated. This code captures evaluations of the anus and rectum performed in an anesthetized setting, which can be necessary for adequate assessment and treatment when conscious examination is insufficient or painful. Nationally, proper use of this code affects procedural reporting, facility and professional payment pathways, and case mix for surgical services.

Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The discussion addresses how this service is typically billed across payers, common clinical contexts that prompt use of an anesthetized anorectal exam, and the places of service where the procedure commonly occurs.

Readers will find benchmarks and practical reference points for coding and billing this service, a concise clinical context outlining when an anesthetized anorectal exam is appropriate, and a summary of payer considerations and documentation expectations. Data not available in the input will be noted where applicable.