Nicoletti Notes August 2025
Published on August 28th, 2025

The July 2025 CPT^® Assistant had a question about whether CPT^® 99459 could be used on a male patient for an examination of external male genitalia and a digital rectal exam. CPT^® said no. 99459 is intended to be used with a pelvic exam to cover “the additional supplies needed by the physician to provide the service (light, speculum, etc.) are included to perform the examination.” (CPT^® Assistant, July 2025, p. 9 copyright AMA). And, by the way, the AMA clarified that a supervising staff member is not required to report 99459 at the 2024 AMA CPT^® symposium.

But it reminded me that CodingIntel’s article on billing for a pap smear remains one of our most frequently read articles.  It’s not “new” news, but I think of it as having perennial interest, since it is the article that attracts many visitors to our site. And when I wonder why it’s so confusing when the coding is relatively unchanged, I look at the bullet points at the start of the article.

“Billing for pap smears in a physician practice can be confusing for clinicians and coders alike.

• Pap smears can be screening services or diagnostic services
• There is a HCPCS code for obtaining a screening pap smear, Q0091
• Performing a pelvic exam is either part of a preventive medicine service or problem-oriented visit
• A new CPT^® code in 2024: add-on code for performing a pelvic exam, 99459 (page down to read about it)”

You can read the article in full here.