NEW HCPCS Codes Established for Coding the Levonorgestrel-Releasing Intrauterine Contraceptive System, 52 mg Intrauterine Device (IUD)
Effective January 1, 2016, CMS will discontinue use of HCPCS code J7302 for 52 mg levonorgestrel-releasing IUDs. There are two 52 mg dosage, levonorgestrel-releasing intrauterine contraceptive systems (IUS), approved for use in the U.S. These devices may be reported with an appropriate HCPCS level II code.
FDA approved indications and product life effectiveness differ between the two products. For example, the Mirena product is currently approved for the treatment of heavy menstrual bleeding in IUD users and for 5 years of contraceptive use, while the Liletta product is currently approved for 3 years of contraceptive use.
HCPCS codes for the 13.5mg levonorgestrel-releasing IUD (J7301) (brand name Skyla) and the intrauterine copper contraceptive (J7300) (brand name ParaGard) remain unchanged.
The coding system is not a methodology for making coverage or payment determinations. Each payer makes determinations on coverage and payment outside this coding process. The descriptors of the codes identify a category of like items or services and typically do not identify specific products or brand/trade names.
ACOG further recommends that you contact your specific payer for their reporting instructions since payer guidelines on this issue may vary. Be sure to get any instructions in writing.
Procedure and Device Coding for Dates of Service on or After January 1, 2016
Potential codes to report are as follows:
– 58300 (IUD Insertion)
– J7297 (Levonorgestrel-releasing intrauterine contraceptive system, 52mg, 3 year
– J7298 (Levonorgestrel-releasing intrauterine contraceptive system, 52mg, 5 year
The specific diagnosis code to report will be determined by the intent and/or medical necessity of the encounter.
Possible ICD–10–CM codes to report are as follows:
– Z30.430 (Encounter for insertion of intrauterine contraceptive device)
– Z30.432 (Encounter for removal of intrauterine contraceptive device)
– Z30.433 (Encounter for removal and reinsertion of intrauterine contraceptive
– Z30.431 (Encounter for routine checking of intrauterine contraceptive device)