How to use CPT 99459 pelvic exam code in 2024 | Medical coding | Urology

Dr. Lin discusses the role of a chaperone in 99459 and numerous questions about the use of this CPT code, with special emphasis on use in urology. This was a Facebook live presentation to The Thriving Urology Practice Facebook group.
CMS 1784-F
Federal Register Vol. 88, No. 220 / Thursday, November 16, 2023:
www.govinfo.gov/content/pkg/F...
The Thriving Urology Practice Facebook Group:
http:/www.Facebook.com/groups/ThrivingPractice
Dr. John C. Lin practices at Sunrise Urology in Gilbert, Arizona.
www.SunriseUrology.com
#PelvicExam #CPT #99459

[@janespitfire9884]

I read it needs to be documented if used during pelvic exam.Document chaperone in treatment room such as nurse, CMA, ETC when doing pelvic exam

[@JCLinMD]

Chaperone won't be needed to use this code.
Stay tuned for updated information.

[@kimberlyshelton5612]

are you seeing reimbursement for this code with all payers or just Medicare?

[@biosailgirl]

So if your salary is RVU Based and you work for a hospital it doesn’t increase your work rvu, just facility rvu- meaning the hospital gets reimbursed by cms but not you?

[@JCLinMD]

Very perceptive! Yes.

[@carriejennings4165]

I'm a medical coder, should the provider document that there was a chaperone during the exam in order to be compliant?

[@JCLinMD]

Latest info is that NO chaperone is needed to bill 99459.
Always good idea to document chaperone present. Can't go wrong there, even if no 99459 code is used.