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

[@samw8452]

Thank you, Dr. Lin!

[@swatirangari3233]

Okay so as per latest update we don't need the chaperone presence documented in emr. Can you please share insurance wise guide for this CPT 99459?As most insurances are denying this CPT.

[@kimberlyshelton5612]

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

[@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.

[@vjc1584]

Can 99459 be used for 3 years old female patient? some forums are discussing it can be used only if patient age is 5 years and more.

[@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.

[@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.