Reader Questions: Report Intrauterine Device and Insertion

Two Codes for IUD and Insertion

Question: When we insert an intrauterine device (IUD), is the cost of the IUD included in the procedure? Should I charge separately for the IUD? We have a new PAR in our obstetrics department who thinks that we should be billing for the IUD insertion as well as the IUD.

Minnesota Subscriber

Answer: Indeed, you should charge separately for the IUD, because the cost of the device isn't considered part of the procedure. You have a couple of appropriate HCPCS codes to choose from, depending on the type of IUD. If the physician inserted a copper IUD, report code J7300 (Intrauterine copper contraceptive). If she inserts another type, such as Progestacert, you should use code S4989 (Contraceptive intrauterine device, including implants and supplies). Note that S4989 is a temporary, non-Medicare code, so check with your intermediary if necessary.

Report -52 for Termination

Question: A non-Medicare patient presented in the emergency room with a 2-millimeter laceration on his eyebrow with a metallic foreign body embedded in it. In efforts to extract the object, our physician surgically extended the laceration to 4 millimeters and probed for the foreign body. Unfortunately, he could not remove it, so he terminated the procedure. Should I code this as 10120, or consider it part of the evaluation and management service and not code it at all?

Missouri Subscriber

Answer: Because the physician attempted the foreign-body removal but could not complete it, you should report code 10120* (Incision and removal of foreign body, subcutaneous tissues; simple) and append modifier -52 (Reduced services). This procedure, although truncated, would not be included in the codes for evaluation and management services. In this case, whether the patient has Medicare should not affect your choice of code.
   

- Reader Questions reviewed by Sarah Goodman, MBA, CPC-H, CCP, president of SLG Inc. Consulting in Raleigh, N.C.