Wiki mirena insertion and reinsertion x 2

ginahill

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We had a patient who had a mirena insertion about a month ago. She came into the office yesterday and had an ultra souond and the mirena had moved and had to be removed. The dr is going to reinsert another one in a couple of weeks. Do you bill the 58300 with the modifier 77 or can you bill the 58300 alone since it does not have a global fee? Please help, new to OBGYN! Thanks, Gina
 
We had a similar situation - the pt's IUD was inserted and "came out" within a month - the physician inserted another IUD - I first checked with the pt's ins to be sure they would cover another IUD in such a short time frame - we then biled the IUD and 58300 with no modifiers- both were paid with no problems.
 
Since it doesn't have a global you don't have to add a modifier. I will add though, that only time we've ever had an issue with this was with Medicaid. In our state, Medicaid has a policy that it will not reimburse for two IUDs within 30 days--no matter what the circumstances were. So beware with Medicaid. :)
 
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