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IUD removal and insertion on the same dos

  1. #1
    Default IUD removal and insertion on the same dos
    Medical Coding Books
    Help please! If previous IUD was removed and new IUD was insterted on the same dos, how do we bill it? Do we need modifier?
    Situation is that pt was seen previously for vaginal bleeding. Ultrasound revealed IUD is likely a cause for the bleeding. So, pt came in for replacement.
    Thank you for your help.

  2. #2
    Not my area of expertise but my opinion is the removal would be included in the original insertion of the IUD. If this is not the case, then I would code the CPT with the highest RVU first, and second with modifier 51. BUT... I'd be inclined to code only the insertion...76 modifier, "repeat procedure by same physician" might be necessary...

    Just a few thoughts...

  3. Default
    There is a CPT Assistant (1998) that addresses removal & insertion of IUD's on the same d.o.s....

    The response was that the insertion does not include the removal...although payors may vary... So it appears that coding both should be fine unless a specific payor has different requirements.
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS

  4. #4
    Thank you very much. I guess will bill both and will see what is going to happen.

  5. #5
    Do you know how can I order CPT Assistant?

  6. Default

    1 (800) 621-8335

    Hope this helps...
    Anthony McCallum, CPC, CIRCC, CPC-I, CCS

  7. Default IUD insertion/removal
    2008 OB/GYN coding companion states - If an IUD is removed and another is inserted at the same time, only the insertion (58300) should be reported.

  8. Default
    Recently ACOG put out an article which recommends billing for both the insertion and removal done at the same visit: whether insurance will pay is another story but we follow ACOG guide lines and I feel we SHOULD bill this way if we are to have anything changed down the road.

  9. #9
    Quote Originally Posted by gsealy View Post
    2008 OB/GYN coding companion states - If an IUD is removed and another is inserted at the same time, only the insertion (58300) should be reported.
    Yes absolutely right. I do follow the same at my work

  10. #10
    Insertion of IUD does include removal. I think the CPT's reasoning is that an old IUD woud be remove and replaced with a new at the same time of service. Removing an IUD is a snap in most cases, just comes right out with a light pull, so it seems fair to me that the removal of the previous IUD be included in the insertion of the new IUD. If the removal is difficult that is another story . . .


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