Ob-Gyn Coding Alert

Check out what Palmetto GBA says you should put in the narrative field.

If your ob-gyn has been treating uterine bleeding in patients with endometrial hyperplasia with intrauterine devices (IUD), then you can expect CMS to start reimbursing this service, according to Palmetto GBA in its February 2012 Medicare Advisory -- but be careful about what CPT code you report.

What happens: Ob-gyns sometimes treat patients who have abnormal uterine bleeding caused by endometrial hyperplasia by inserting an IUD -- especially when the patient with abnormal uterine bleeding cannot not tolerate (or are at high risk for complications of) oral megestrol.

In the event your ob-gyn performs this service for this reason on a Medicare patient, you should report 58999 (Unlisted procedure, female genital system) and not 58300 (Insertion of intrauterine device [IUD]). The reason is that Medicare will not reimburse 58300, because this is a procedure code to insert a contraceptive device. CMS will automatically deny claims with 58300.

More tips: For your diagnosis, you should choose from ICD-9 codes 621.30-621.34. You should also enter "hormone IUD" in the comment/narrative field.

This bulletin comes from Palmetto GBA, a jurisdiction 1 Medicare administrative contractor (J1 MAC). They will pay for claims effective for dates of service on or after Feb. 1, 2012. Read more here: www.palmettogba.com/Palmetto/Providers.Nsf/files/February_2012_Advisory_J1B.pdf/$File/February_2012_Advisory_J1B.pdf.