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December 2016 Texas Medicaid Provider Procedures Manual

Gynecological, Obstetrics, and Family Planning Title XIX Services Handbook : 2 Medicaid Title XIX Family Planning Services : 2.2 Services, Benefits, Limitations, and Prior Authorization : 2.2.5 Contraceptive Devices and Related Procedures : 2.2.5.2 Intrauterine Device

2.2.5.2
2.2.5.2.1
The IUD and the insertion of the IUD may be reimbursed using procedure code J7297, J7298, J7300, J7301, and 58300.
When a vaginal, cervical, or uterine surgery procedure code is submitted with the same date of service as the IUD insertion procedure code, the following reimbursement may apply:
Procedure codes J7297, J7298, J7300, and J7301 may be reimbursed when they are billed with one of the following diagnosis codes:
 
2.2.5.2.2
Procedure code 58301 may be reimbursed when an IUD is extracted from the uterine cavity. An office visit will not be reimbursed when billed on the same date of service as procedure code 58301.
When a vaginal, cervical, or uterine surgery procedure code is submitted with the same date of service as the IUD removal procedure code or the IUD replacement procedure code, the following reimbursement may apply:

Texas Medicaid & Healthcare Partnership
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