tfypoo
New
A patient was seen to have 2 Nexplanon devices removed. Can you bill the removal procedure twice?
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Wiki Nexplanon Removal
- Thread starter tfypoo
- Start date
nielynco
True Blue
Please provide a description of the procedure performed (ie, providers notes) so we can better help you with this.
tfypoo
New
HPI - The patient presents today for Nexplanon removal. She has two devices in place in her left arm. She was previously counseled, and all questions have been answered to her satisfaction.
Procedure Documentation -
Risks, benefits, indications and alternatives for the procedure were reviewed with the patient. All questions were answered. Informed consent was obtained. Post-care instructions were given to the patient.
Patient desires the removal of the device and was informed fertility will resume.
The insertion site was identified, and cleaned with Betadine. Local anesthesia was achieved with both topical anesthetic and Lidocaine 1% with Epi. A scalpel was used to incise the skin over the implant's distal end of the rod and was milked toward skin incision. A small hemostat was used to grasp and remove the implant.
A standard dressing was then applied over the insertion site. A pressure bandage was also applied.
The patient was instructed to remove the pressure dressing in 24 hours.
The patient tolerated the procedure well. She was monitored per protocol and discharged home after meeting criteria.
Last edited:
nsteinhauser
Expert
Have you looked at 11982?
tfypoo
New
Yes that is the code we use for a Nexplanon removal. My question is since the patient has 2 Nexplanon implants in her arm can I bill 11982 twice.
tfypoo
New
Thank you!
Korbc
Expert
does anyone know how to charge for a removal and insertion and removal again in the same visit because she had numbness from hitting a nerve when they reinserted the new one so immediately removed the new one.
also I was told you could get reimbursement from the manufacturer for the Nexplanon and told to charge the device to insurance. but i would think if we're getting reimbursed from the manufacturer not to charge insurance because wouldn't that be double dipping?
also I was told you could get reimbursement from the manufacturer for the Nexplanon and told to charge the device to insurance. but i would think if we're getting reimbursed from the manufacturer not to charge insurance because wouldn't that be double dipping?
nielynco
True Blue
I would report 11983 with a modifier -22 if the removal time was significant. If is was just slipped in and immediately slipped out I think I would report 11983 with no modifier. If you are being reimbursed by the manufacturer you should not be billing insurance. But you could bill insurance, and if they refuse to pay, contact the manufacturer.
Korbc
Expert
Thank you a ton as always!
No one is asking about charging and E/M code. So I'm curious. My providers are charging a 99212. Does anyone else charge e/m codes with insertion, removal or both?
I would charge an E&M only if an E&M was provided. At whatever level was documented. Always a 99212 (or any "always" level) makes me raise an eyebrow.
From the original poster here, the documentation supplied was a procedure only and would not support any E&M level.
Korbc
Expert
Unless there's a separate issue addressed and enough e/m for it then I don't charge an e/m. There's a small amount of e/m already built into procedures already, so if they are there for just that and it's just the procedure I just charge the procedure. Also often times counseling done regarding the procedure was done prior to the visit for my practice.
ACOG has a LARC coding guideline, but to reiterate what was said above, a provider should not be standardly charging an E+M in this situation. Here is a snip from a PDF version
Thank you!
Thank you!
Thank you!