Ob-Gyn Coding Alert

Question: I just found out about a new contraceptive injection called Lunelle. What code should I use for this service?

Missouri Subscriber

Answer: Lunelle is a contraceptive that contains 25 mg of medroxyprogesterone and 5 mg of estadiol cypionate. Because this is a relatively new product, you'll probably have to use 99070 (supplies and material [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]) unless the payer insists on your using a HCPCS J code. In that case, the closest code would be J3490 (unclassified drugs) because HCPCS does not have a single J code that represents this formulation. Be sure to include information about the drug when submitting either of these two codes including the drug name, dosage and National Drug Code Number (from the package insert).