Wiki skyla iud

[cooper1]

Has anyone else had problems getting skyla iud paid? Office billed 58300 J7301 and 81025 but they are saying J7301 is mutally exclusive. any help please

 

[Pam Warren]

We typically give the patient a script for the IUD, which they obtain from the pharmaby and then bring in. It's a prescription, and often has to be applied to the patient's pharmacy plan. If the IUD is not one that is covered by the plan, you're going to get denied.

 

[Bready]

you don't state if the denial was commercial carrier or government, but Texas Medicaid as of 6/1/14 stated it was no longer necessary to bill the IUD with the procedure code(58300) to receive reimbursement for the device. If the carrier is saying the Jcode is included with the procedure code make sure the reimbursement reflects the cost of the IUD. If your reimbursement doesn't include the cost of the IUD, you will need to call the carrier for an explanation and it could very well be that this particular IUD is not reimbursable under the patient's plan.

 

[kenkie79]

We usually get paid if it is covered by the medical plan. Otherwise, the patient has it sent to us through their pharmacy plan. It would be necessary to know what type of insurance the patient has, however.