Wiki Nexplanon

[encomma-watson]

I did a claim review for CPT code 99214, FP modifier, (Family planning Medicaid)
CPT code 11983, FP (Removal w/reinsertion of implant)
and HCPCS J7307UD, FP modifiers (Etonogestrel Implant system including implant and supplies.

Am I billing correctly for a provider who is not a GYN Provider but has been trained to do this procedure. Can anyone help me on this?

 

[Cmama12]

Hi, my understanding with the FP modifiers is that you don't need them if you are using a contraceptive management dx code, eg, Z30.46. However, that could differ by state.
If this was a removal and reinsertion as you indicate, I question why a 99214 is being charged additionally.
The J code would also need the NDC information attached.