Get Up to Speed With New Reporting Rules for IUS Contraceptives

Coding and Billing of Contraceptive Services and Procedures, New HCPCS Coding for the Levonorgestrel-Releasing Intrauterine Contraceptive System, Contraceptive coding and billing guidelines, contraceptive services

When LARC Doesn’t Refer to Birds

Coders working in gynecology practices know that LARC is an acronym for long-acting reversible contraception, a group of contraceptive systems including intrauterine contraception systems (IUS) and subdermal rod implants like Nexplanon. LARC, then, is an umbrella term for methods that prevent pregnancy for extended time periods without requiring the user to take regular action, such as swallowing a pill or using a condom.

Welcome to a New Age for Contraception

Intrauterine device (IUD) contraceptives have been around for a long time, but the intrauterine devices in the LARC category are different — they are easier to use, safer, longer lasting, quickly reversible — and 20 times more effective than oral contraceptives, according to researcher Donna Shoupe, whose article on LARC methods was published in the February issue of the journal Contraception and Reproductive Medicine. Shoupe adds that in the US, currently 12 percent of all reproductive-age women use LARC methods for their contraception, a significant increase from 2 percent in 2002.

Note that 2016 brings changes to HCPCS coding for levonorgestrel-releasing intrauterine contraceptive systems, with two codes brand new for this year.

  • For Mirena, the product approved for treating heavy menstrual bleeding in IUD users, with five years of contraceptive effectiveness, you’ll report J7298 (Levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 5 year duration).
  • For Liletta, an intrauterine contraceptive system approved for three years of contraceptive effectiveness, you’ll report J7297 (Levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 3 year duration).

The HCPCS J codes for two other popular IUS products have not changed. Supplies of Skyla, the IUD that releases levonorgestrel in a lower dose, and Paragard, the copper IUD, are still reported with the following HCPCS codes:

  • For Skyla: J7301, Levonorgestrel-releasing intrauterine contraceptive system, 13.5 mg
  • For ParaGard: J7300, Intrauterine copper contraceptive.

Heads Up — Cross J7302 Off Your List!

The old J code for the 52 mg versions of levonorgestrel IUS products is no longer valid. As of January 1, the Center for Medicare and Medicaid Services (CMS) deleted HCPCS code J7302 (levonorgestrel-releasing intrauterine contraceptive system, 52 mg) and replaced it with the two codes J7297 and J7298 that we talked about above.

Don’t Forget the CPT® and Diagnosis Codes

Of course the HCPCS codes shown above are only used to report the supply of the IUS itself. You’ll also need to report the device’s insertion and/or removal with an appropriate CPT® code, such as the following:

  • 58300, Insertion of intrauterine device (IUD)
  • 58301, Removal of intrauterine device (IUD).

Choice of diagnosis codes will vary with the patient’s situation and of course the provider’s documentation. However, a few ICD-10-CM codes to consider include the following.

  • 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 device
  • Z30.431, Encounter for routine checking of intrauterine contraceptive device.

What About You?

If your practice serves reproductive-age women, tell us your experience with LARC products. Are more of your patients opting for these? Has increased popularity of IUS systems raised any issues for your practice, such as the cost of stocking the devices? Let us know in the comment box below. We love to hear from you!

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About 

Susan taught health information and healthcare documentation at the community college level for more than 20 years. She has a special love for medical language and terminology. She is passionate about ensuring accurate patient healthcare documentation through education. She has a master's degree in healthcare administration, is a certified healthcare documentation specialist, and serves as immediate past president for the Association for Healthcare Documentation Integrity (AHDI).

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