July 14, 2015

State of Alabama
Press Release: Medicaid

Coverage of Liletta IUD under the Plan First/Family Planning Program


TO:     All Family Planning Providers (physicians, FQHC, IRHC, PBRHC), Hospitals, Obstetricians-Gynecologists, and Plan First Providers

RE:    Coverage of Liletta IUD under the Plan First/Family Planning Program


Effective for dates of service August 1, 2015, and thereafter, the Alabama Medicaid Agency will begin coverage of the Liletta Intrauterine Device (IUD). Currently, Liletta is approved for only 3 years of continuous use. Providers will use HCPCS Code J7302 to bill for a Liletta IUD, the same HCPCS code currently used to bill for a Mirena IUD.

Effective for dates of service August 1, 2015, and thereafter, providers will use HCPCS Code J7302 with modifier FP (J7302- FP) to bill for a Mirena IUD.

The following HCPCS codes are applicable:
•    J7302           Liletta IUD
•    J7302-FP     Mirena IUD

The following CPT codes are applicable:
•    58300             Insertion of intrauterine device
•    58301             Removal of intrauterine device

The following Diagnosis Codes must be billed in conjunction with the above HCPCS and CPT codes in order to be reimbursed by Medicaid. ICD-9 diagnosis codes should be used for claims submitted with dates of service on or prior to September 30, 2015.

    ICD-9 Diagnosis Codes:

•    V2502            Initiation of other contraceptive measures
•    V2511            Encounter for insertion of intrauterine contraceptive device
•    V2512            Encounter for removal of intrauterine contraceptive device
•    V2513            Encounter for removal and reinsertion of intrauterine contraceptive device
•    V2542         Checking of intrauterine contraceptive device

ICD-10 diagnosis codes should be used for claims submitted with dates of service October 1, 2015, or after:    
    ICD-10 Diagnosis Code:

•    Z30014        Encounter for initial prescription of intrauterine contraceptive device
•    Z3043            Encounter for insertion of intrauterine contraceptive device
•    Z30431        Encounter for routine checking of intrauterine contraceptive device
•    Z30432        Encounter for removal of intrauterine contraceptive device
•    Z30433        Encounter for removal and reinsertion of intrauterine contraceptive device

Place of service:
•    11         Office visit
For questions regarding billing for the Liletta or Mirena IUDs, contact Sylisa Lee-Jackson, Associate Director, Maternity, Plan First/Family Planning and Nurse Midwife Programs at 334-353-4599 or via email at sylisa.lee-jackson@medicaid.alabama.gov.

 



 



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