# Medicare and J7307



## smaher82 (Mar 9, 2015)

We are getting denials from Medicare for nexplanon for HCPS code J7307. The denial reason is M51: Missing/incomplete/invalid procedure code(s) and/or dates.  Is anybody else getting denials? Is there another code for Medicare only?


Thanks


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## mitchellde (Mar 9, 2015)

What other codes are using with it?


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## smaher82 (Mar 9, 2015)

11981 for the insertion  with Icd 9 code  of V25.5


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## mitchellde (Mar 9, 2015)

Does Medicare cover contraceptives?


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## roxvaughn (Mar 9, 2015)

I'm pretty sure Medicare doesn't cover contraceptives. First of all it is a preventive service. The patient's should sign ABN forms for these serivces. 

Roxana Bejinariu, CPC


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## mitchellde (Mar 9, 2015)

That is what I thought also Roxana.  If the drug is being for other reasons then Possibly it would be covered but not for contraceptive purposes.


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## epwjfh (Mar 18, 2015)

We also got a denial from CGS Medicare for J7307 missing or invalid code.  Has anyone had any additional information regarding this denial?  When I called Medicare, they told me Medicare does not cover contraception.  The denial was not denied as member responsibility, therefore unable to receive payment from Medicaid.  Any suggestions would be appreciated.


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