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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 : Immediate Postpartum Insertion of IUDs and Implantable Contraceptive Capsules
Procedure codes J7297, J7298, J7300, J7301, and J7307 may be reimbursed in addition to the hospital diagnosis related group (DRG) payment when insertion is performed immediately postpartum. “Immediately postpartum” refers to insertion within 10-15 minutes of placental delivery, after vaginal or cesarean delivery, for IUDs or insertion prior to discharge for implantable contraceptive capsules.
When seeking reimbursement for an IUD or implantable contraceptive capsule inserted immediately postpartum, hospital/facility providers must submit an outpatient claim with the appropriate procedure code for the contraceptive device in addition to the inpatient claim for the delivery services.

Texas Medicaid & Healthcare Partnership
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