# Embedded IUD



## ahagan@thewomenspavilion.com (Dec 4, 2014)

A patient had IUD inserted 2 weeks ago, came back in for IUD recheck via U/S.  IUD was embedded in uterine wall and upon attempt to reposition IUD - it was pulled out.

New IUD was inserted.  Can I bill for the new device and insertion?  If so what codes should I use?


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## 1formissy (Dec 5, 2014)

You can bill for the new device and insertion. I assume the payer you are billing covers contraceptive management? 
Did the provider use the Mirena? Or was it the copper one? (ParaGard T) 
If the provider used Mirena, you would code J7302. 
ParaGard is J7300
Although some CPT codes are combination codes (e.g., code 11983 for a subcutaneous drug delivery implant removed and reinserted at the same time) the CPT Manual does not include a code that represents both an IUD insertion and an IUD removal performed on the same day. When a physician performs both of these procedures on the same day, coders must report codes 58300 and 58301. Append modifier -51 to code 58301. The physician documentation and the diagnoses reported for each service on the insurance claim should support the reasons for the removal and re-insertion of the IUD during the same procedural setting. 
must also report the correct diagnosis codes to denote with IUD insertion and/or removal. For the insertion of the IUD, report one of the following V codes (these are the only codes that denote insertion of an IUD):

V25.1 (Insertion of intrauterine contraceptive device)

V25.42 (Surveillance of previously prescribed intrauterine contraceptive device; checking, reinsertion, or removal of an IUD)


In addition to V25.42, the following codes are commonly used to denote removal of an IUD 

996.32 (Mechanical complication due to intrauterine contraceptive device)
996.65 (Infection and inflammatory reaction due to other genitourinary device, implant, and graft)
996.76 (Other complications due to genitourinary device, implant, and graft)


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## ahagan@thewomenspavilion.com (Dec 8, 2014)

*Iud*

Missy - I suppose the real question is was their actually a device issue since the device really didn't fail, but was embedded in uterine wall?  Does this matter in terms of ICD9 codes that state "mechanical failure of device"?


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## 1formissy (Dec 8, 2014)

I would say it is a mechanical failure, since it failed to do what it is intended to do. That's what I used to report when I coded for a OB/GYN clinic.


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