Wiki Nexplanon-Can someone help

[PMcCaffrey]

Can someone help with coding for Nexplanon insertion. Can you bill for both the device and the insertion?

 

[astough]

Yes, you can bill for both. We use V25.5 for the dx, J7307 for the Nexplanon and 11981 for the insertion.

 

[Thouvenel]

Do you have problems getting paid for the removal? Oklahoma medicaid is denying V25.43 for LCD.....

 

[Charlotte Kay]

Nexplanon

Can you bill for insertion and supply
11981
J7307
V25.5

However, you cannot bill the Removal on the same day 11982, V25.43 because the
11981 & 11982 are bundled into each other.

 

[jenn0609]

Be careful!! It depends on the insurance benefits and the way that your office stocks/orders the device. If the patient is covered under pharmacy benefits and the office orders it and has it delivered through the specialty pharmacy, you would NOT bill for the device. This is because it has already been paid for by them and the patient (if she has any co-ins or deductible). If the office orders them and stocks them in the office as a "supply" and used them when needed for a patient, they yes you do bill for the device.