Primary Care Coding Alert

Question: Can I bill injectable contraceptives separately from counseling services?

California Subscriber

Answer: Yes, you can bill injectable contraception separately from either a preventive counseling-only encounter or a preventive medicine visit on the same date of service.

For example, let’s say your provider administered Depo-Provera to a patient at the time of the annual preventive visit, you can go ahead and bill J1050 (Injection, medroxyprogesterone acetate, 1 mg) for the supply along with 96372 (Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular) for the injection itself.

Remember: the quantity billed for J1050 is equal to the dosage injected (e.g., 150 mg would be a quantity of 150).

You can report this contraceptive service separately from the annual preventive visit because the guidelines preceding preventive visit codes 99381-99397 (Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures…) in CPT^® state, in part, “Vaccine/toxoid products, immunization administrations, ancillary studies involving laboratory, radiology, other procedures, or screening tests (eg, vision, hearing, developmental) identified with a specific CPT^® code are reported separately” (emphasis added).

Keep this in mind for intrauterine devices (IUDs) also. If your provider opts for insertion for one of the following intrauterine devices, then you’ll be able to bill for the supply along with 58300 (Insertion of intrauterine device (IUD)) for the service.

• J7297 (Levonorgestrel-releasing intrauterine contraceptive system (Liletta), 52 mg)
• J7298 (Levonorgestrel-releasing intrauterine contraceptive system (Mirena), 52 mg)
• J7300 (Intrauterine copper contraceptive)
• J7301 (Levonorgestrel-releasing intrauterine contraceptive system (Skyla), 13.5 mg)
• J7307 (Etonogestrel (contraceptive) implant system, including implant and supplies)