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2012 Texas Medicaid Provider Procedures Manual

Gynecological and Reproductive Health and Family Planning Services Handbook : 4. Department of State Health Services (DSHS) Family Planning Program Services : 4.2 Services, Benefits, Limitations, and Prior Authorization : 4.2.5 Contraceptive Devices and Related Procedures : 4.2.5.3 Contraceptive Capsules

4.2.5.3
The contraceptive capsule and the implantation of the contraceptive capsule may be reimbursed using procedure code J7307 and procedure code 11981 (implantation). Procedure code 11981 may be reimbursed when billed with an appropriate family planning diagnosis code.
Progesterone-containing subdermal contraceptive capsules (Norplant) were previously used for birth control. Although subdermal contraceptive capsules are no longer approved by the FDA, the removal of the implanted contraceptive capsule (diagnosis code V2543) may be considered for reimbursement with procedure code 11976 (removal).

Texas Medicaid & Healthcare Partnership
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