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Wiki Implanon Insertion

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clentz

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Hendersonville, NC
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We are trying to bill for the Implanon insertion and a few insurance are not covering code 11975, but are paying for the J7307. We had an insurance company today tell us the 11975 is not covered but the 11981 is covered under the patients plan. Per the Implanon web site they say you can bill either the 11975 or the 11981. Is it correct to bill the 11981 for this plan?


Ask the representative if IMPLANON is covered. You may be asked to provide the following codes:

NDC: 0052-0272-01 or 00052-0272-01

Billing code: J7307

Insertion procedure codes: 11981 or 11975
(These are possible codes your insurance provider may use. Merck makes no guarantee that the use of any particular code will result in coverage or reimbursement.)




Any help would be appreciated!

Carlin Lentz
 
When I bill the Implanon (J7307) I bill the Implanon insertion with 11975 and have never had a denial.
 
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