Wiki vaginal exam under anesthesia

[mdgask]

We have a patient that will be getting a vaginal exam under anesthesia as an outpatient in the hospital and she will also have a Mirena IUD insertion at the same time. The hospital said we will need to supply the Mirena because they do not keep these in stock. What is the proper billing for the exam and the Mirena IUD insertion? We need to be reimbursed for the Mirena device. The diagnosis for the exam is stenosis of the cervix.

 

[Amy Pritchett]

The insertion of the Mirena is the primary procedure. The vaginal examination under anesthesia is considered "inherent" to the procedure and therefore is not billable (see www.cms.gov/NCCI). In regards to your question regarding the purchase of the Mirena, does your office keep these in stock? If so, the HCPCS code J7302 should be billed on the same claim as the physician's charges for the 58300 CPT code for the insertion of the Mirena.

I hope this answers your question