iud insert same time as delivery

[klapetri@ilovemygyn.com]

My physician preformed vaginal delivery (59400) and immediately after insert IUD (58300).
Can both CPT codes be billed? If so what modifiers?
I appreciate your help

 

[SharonCollachi]

Edited to fix type of implant: For this scenario, ACOG states to bill:

59400 with dx 080, Z37.0, Z3A.40
58300-51 and J7300, dx Z30.430

 

[klapetri@ilovemygyn.com]

Physician preformed vaginal delivery and then inserted IUD..same day
I know IUD insert would be reimbursed during postpartum period under LARC but this is the same day...

Can you send me ACOG article?

 

[SharonCollachi]

It appears it is only available to paid members now. It is a cached copy. However, the scenario they present is very specific. After some background, the question for this scenario is, "How should Dr. C code for the global obstetric
care and immediate postpartum IUD insertion?" And what I gave you is the answer. The first answer I put before I edited it was not a copper IUD.

 

[klapetri@ilovemygyn.com]

Can you please send me article?

I received a denial from Healthfirst. Not paying on 58300 modifier 51
"These services are not covered when performed within the global period of another service"

 

[SharonCollachi]

Here are the coding scenarios.

However, just because ACOG says to do it that way does not mean that a particular payer is going to pay it that way. I would suggest in the future to check benefits early in the pregnancy.

 

[klapetri@ilovemygyn.com]

We do verify benefits during pregnancy.

It's a Medicaid policy, to my knowledge NYS medicaid, pays for emergency contraceptive .....

 

[SharonCollachi]

Is an IUD considered emergency contraceptive now?

 

[fwnewbie]

An IUD immediately after delivery?? Aren't there concerns of sepsis?

 

[pcampbell135]

We bill 59400
58300-59
We do not bill the J code when coding for the physician services as the IUD itself is supplied by the hospital.

 

[SharonCollachi]

An IUD immediately after delivery?? Aren't there concerns of sepsis?

I thought so as well at first, but the National Institutes of Health says that risk of complications is the same as an IUD placed later.

 

[klapetri@ilovemygyn.com]

Correct we only billed 58300 and healthfirst is denying "These services are not covered when performed within the global period of another service"

 

[SharonCollachi]

Correct we only billed 58300 and healthfirst is denying "These services are not covered when performed within the global period of another service"

And what did the insurance tell you when you checked the benefit before delivery?

 

[klapetri@ilovemygyn.com]

will consider separate reimbursement for the following contraceptive management services when provided during the postpartum period. 
Insertion, non-biodegradable drug delivery implant 
Diaphragm or cervical cap fitting with instructions 
Insertion of intrauterine device, (IUD)