# coding for insertion of Nuva Ring, with instruction and training



## arrana (May 7, 2013)

We have a patient who came in for her Nuva Ring to inserted, and the provider also did instruction and training with the patient. What would be the appropriate diagnosis and procedure coding for this visit? The provider coded with V25.09 and 99213. 

All suggestions appreciated.


Thanks,
Arrana Ashton, CPC


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## alosiewski (May 7, 2013)

*NuvaRing*

I believe she is correct.  You could possibly get a bit more specific with the contraceptive DX by using code V25.02 (Initiation of other contraceptive measures), if the provider is prescriping the NuvaRing.  I don't believe you would bill for the procedure because it is a device that the patient inserts themself.  The visit sounds like it was more educational.


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## lbarbour (May 7, 2013)

I used to work in OB years ago. If the doc insert the contraception in the office you need a procedure code and a device code.  Check to see if its the initial insertion or replacing it.  If so, the codes below will be different.

nuvaring - J7303
since she did counseling, E/M is needed with 25 mod and V25.02 
use V25.11 for insertion of the device
use 58300 for procedure

Hope this helps you out a little!

Lenora Barbour, CPC, CPC-I


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## arrana (May 8, 2013)

58300 is for IUD insertion, Nuvaring isn't an IUD, so I don't think that is right. And it wasn't counseling so much as teaching the patient how to insert and remove. I'm okay using the 99213, but not sure it will pay with the V25.09 (this code is not designated as a PDx in ICD-9). 

Also, I was wondering about 11981, insertion of non-biodegradable drug delivery implant, if that could be appropriate in this situation?

Thanks again.


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## 01jackson (May 8, 2013)

Bill the appropriate E/M 
Nuva ring J7303 (if this is a physician office) ( I work in the teaching setting)

V25.02 ( the counseling included- If the physician prescribe the device - the physician must tell the patient how use the device.)

Also, I was wondering about 11981, insertion of non-biodegradable drug delivery implant, if that could be appropriate in this situation?

Inappropriate to use this code - implant is subdermal. The patient can't take the implant in and out.

Hope this helps.


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## loribeth15 (May 10, 2013)

In our clinic we have a sample Nuvaring to send home with patient to use until their script is filled. The physicians do not insert them! They do however give the patient instructions and answer any questions that they have. And yes if this is the first time giving the patient this script we would use the V25.02 and code an E&M level for the contraceptive management service they have provided.


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