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Thread: Billing for Mirena Device

  1. #1

    Default Billing for Mirena Device

    AAPC: Back to School
    Does anyone know if you are able to bill for the device prior to it being inserted. Our office orders the devices per patient and sometimes it sits in our office for months prior to the patient actually coming in to have it inserted. It seems like we should be able to bill their insurance for the device since it was ordered for them.

  2. #2
    Join Date
    Apr 2007
    Albany, New York


    What if the patient changes their mind and decides not to have the device placed?
    Karen Maloney, CPC
    Data Quality Specialist

  3. #3
    Join Date
    Apr 2007
    Duluth, Minnesota


    I think that might be bordering on "fraud"... a bit... Patient might not come in, worse yet, could die....never come back - how then could it be justified that this patient was charged for a supply never used?....

    in short, no - you can't charge a patient for something that hasn't been supplied to them...
    Donna, CPC, CPC-H

  4. #4


    NO, you cannot bill the insurance for the IUD prior to it being inserted. In the future you can ask the patient for a $50 deposit in order for your office to obtain an IUD for them. Let them know the $$$ will either be refunded to them or they can opt to have it go to their co-ins, deduct etc AFTER the ins has been billed and has made payment.

    Many offices have resorted to having to do this as it is very expensive for the practice to have to purchase the Mirena IUD up front.
    Kelly Long CPC, CFE
    Manager Audit and Compliance

  5. #5
    Join Date
    Apr 2007
    Columbus, Ohio


    You could also have the patient order it themselves and bring it to the office w/ them that way they will definately come to have it inserted. I know Mirena has a payment plan they can set the patient up w/. Trust me I know how expensive they are! We order ours by bulk and keep them in office because they fly off the shelves here! It stinks that we can't charge the patient for the time and effort we put into it but hey that's life! Hope this helps.

    Karey, CPC

  6. #6


    We also keep a supply on hand, as we go through them rather quickly. However, we have called the prescription into the patient's pharmacy so that might be an option for you.

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