Wiki Billing Nexplanon device and insertion to BCBS.

[Dyoung14]

We are having a lot of issues with BCBS denying J7307 and 11981 stating that CMS has revised J-code format...? and that we need to be using a different dx code. We've been using Z30.46 but, it will no longer pay. Has anyone else had any trouble billing J-codes to BCBS? I would appreciate any help.

 

[CodingKing]

J code is still active. I wonder if it has to do with DX as the one you lists is for Removal, removal with reinsertion or just a check up.

Insertion only I believe is Z30.017 - Encounter for initial prescription of implantable subdermal contraceptive[FONT=&quot]
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[garciablanca89]

Help billing CPT Code 11981

Is this the correct code to bill Nexplanon in a PCP setting?
It pulls up as a anesthesia code ; HELP anyone!

 

[Cmama12]

11981 is the only code for insertion of Nexplanon. It is not an anesthesia code.

 

[vjensenbfp]

Nexplanon denial

Our denials is for the unit of measure. Mg??

 

[minchumina]

Units

I use the "UN" on the NDC code line of information for measurment indication