AAPC - Back to school
Page 2 of 2 FirstFirst 12
Results 11 to 14 of 14

Thread: billing Medicaid - I have a scenerio

  1. #11


    AAPC: Back to School
    Quote Originally Posted by FasTrack View Post
    we learned from a drug rep that SC medicaid will pay for "sounding" of the uterus(57800) and surgical tray(a4550) as well as insertion(58300), product(j7300 or j7302) and a pregnancy test(81025) if patient is menstrating at the time of her appointment. Sorry I don't have any specifics on Medicare/Medicaid. We bill all 5 codes for all insurance companies but often have to w/o 57800 for some of the commercial insurance companies.
    I was just wondering can anyone please point me in the direction of these type of codes (a4550). We never before billed for it and I was wondering where can I find a discription of what exactly is this code (besides "surgical tray) and I am sure there is some sort of a book that I don't know of.


  2. #12
    Join Date
    Apr 2007


    the procd codes will be find in the cpt book (insertion & removal 58300 & 58301 using diag v25.1 & removal v25.42), also contact the medical supplier tht provide the iud ie Mirena which they have a website with all the info related to their product

  3. #13


    is your patient on family planning take charge program? We are able to get medicaid to pay on the J7302 and the 58300, but have had a patient that was take charge only and we got the denial of we are not authorized to do this service. We are with medicaid, we are not registered with the Take Charge program, which is done separately. Trina

  4. #14
    Join Date
    Apr 2007

    Smile Bonny

    In WA state, we are not contracted to accept Take Charge so if that's the patien'ts plan, we refer them to Family Planning. If they hae any other Medicaid coupon we get reimbursed for the insertion, 58300, the method, J7300 or J7302, a pregnancy test, 81025 and and E&M code, if approp. with modifier 25. They will not pay the surgical tray & I've never tried the uterine sound code.
    One reason you may not be reimbursed is based on your provider type and yur Core Provider Agreement with Medicaid. Check with your provider rep about that. Also, I've had private payers try to deny the IUD as they only cover prescription dispensed at the pharmacy. I have won every appeal based on this method can only be inserted by the provider and not by a pharmacy.

    Good luck!

Page 2 of 2 FirstFirst 12

Similar Threads

  1. Billing hysteroscopy with IUD insertion
    By scurtis7189 in forum OB/GYN
    Replies: 0
    Last Post: 07-01-2015, 10:11 AM
  2. IUD Insertion
    By gonzalesl2010 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 06-19-2015, 11:19 AM
  3. Iud re-insertion help!
    By NIEVESM in forum Family Practice
    Replies: 1
    Last Post: 09-03-2010, 04:00 PM
  4. Iud insertion
    Replies: 4
    Last Post: 06-13-2009, 12:09 PM
  5. Insertion IUD
    By SIMINO in forum OB/GYN
    Replies: 0
    Last Post: 05-14-2008, 11:10 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.