CPT Code 58300: Intrauterine Device (IUD) Insertion

CPT code 58300 covers IUD insertion for contraception. Learn billing rules, documentation needs, modifiers, diagnosis codes, and related codes.

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What is the CPT code 58300?

CPT code 58300 refers to the insertion of an intrauterine device (IUD), a widely used form of long-acting reversible contraception. During this procedure, a healthcare provider places a small, T-shaped device into the uterine cavity. The IUD may be hormonal—like Mirena or Kyleena—or non-hormonal, such as the copper-based Paragard. The choice of device typically depends on the patient's medical history, preferences, and long-term contraceptive goals. This insertion of intrauterine contraceptives supports preventive services by offering reliable birth control options tailored to the patient's condition.

It’s important to note that CPT 58300 covers only the procedure of inserting the IUD. The cost of the actual device is billed separately using an appropriate Healthcare Common Procedure Coding System (HCPCS) code (e.g., J7296–J7301), which corresponds to levonorgestrel releasing intrauterine contraceptive devices and other types. This code is commonly used for first-time insertions or reinsertions following IUD removal. When both removal and insertion occur during the same visit, providers must also report CPT 58301 for the removal and may need to append Modifier 51 to account for multiple procedures on the same day.

Overall, CPT 58300 plays a key role in accurately documenting and billing for IUD insertion, ensuring both clinical and administrative precision in contraceptive care. For example, a provider might bill CPT 58300 during an office visit where a patient chooses a Skyla device—a levonorgestrel releasing intrauterine system—based on counseling and documentation linked to her symptoms and diagnosis code.

CPT Code 58300 documentation requirements

The documentation requirements for CPT Code 58300 (Insertion of intrauterine device [IUD]) include the following key elements to ensure accurate coding, billing, and compliance:

Written consent from the patient for the IUD insertion procedure.
Type of IUD device inserted, specifying whether it is hormonal (e.g., Mirena, Kyleena, Skyla) or copper-based (e.g., Paragard).
Details of the insertion method used by the provider.
Lifespan or duration of effectiveness of the specific IUD brand inserted, such as a levonorgestrel releasing intrauterine contraceptive.
Appropriate ICD-10-CM diagnosis code, typically Z30.430 (Encounter for insertion of intrauterine contraceptive device), to support claims.
Any complications or risks encountered during the procedure must be documented and maintained in the medical record.
If the procedure was discontinued, documentation must explain the reason and support the use of modifier 53.
If the insertion required substantially increased time, effort, or technical difficulty, documentation should clearly describe these factors to justify use of modifier 22 or 59.
When both removal and insertion are performed on the same day, documentation should support the use of modifier 51 with CPT 58300.
Documentation should include the provider’s legible signature and be part of the official medical record. Accurate reporting ensures services performed are appropriately paid and supported with clinical reasoning.

CPT code 58300 billing guidelines

The billing guidelines for CPT Code 58300 (Insertion of intrauterine device [IUD]) include the following important points:

Use CPT 58300 exclusively for the insertion procedure of an IUD. Do not use it for removal; removal is reported separately with CPT 58301
Bill the IUD device separately using the appropriate HCPCS codes (e.g., J7296, J7297, J7298, J7300, or J7301), as CPT 58300 covers only the insertion procedure, not the device itself
For Medicare patients, CPT 58300 is generally non-covered for contraceptive devices. When billing Medicare, apply modifier GY to indicate a non-covered service, which will trigger an auto-denial
When insertion and removal occur on the same day, report CPT 58301 for removal and CPT 58300 with modifier 51 for insertion to indicate multiple procedures
If the procedure is started but discontinued, use modifier 53 with CPT 58300 to indicate a discontinued procedure
If the insertion requires significantly increased effort or time, modifier 22 may be appropriate, supported by detailed documentation
Use appropriate diagnosis codes such as Z30.430 (Encounter for insertion of intrauterine contraceptive device) to support medical necessity and proper billing
Ultrasound guidance, if used for difficult insertion, should be billed separately with the appropriate ultrasound CPT codes, as it is not included in 58300

Other relevant CPT codes

58301: Removal of intrauterine device (IUD)
76998: Ultrasonic guidance, intraoperative
J7296: Levonorgestrel-releasing IUD (Kyleena®) 5 years
J7297: Levonorgestrel-releasing IUD (Liletta®) 6 years
J7298: Levonorgestrel-releasing IUD (Liletta®) 6 years
J7300: Copper IUD (Paragard®) 10 years
J7301: Levonorgestrel-releasing IUD (Skyla®) 3 years

Frequently asked questions

Yes, with modifier 25 on the E/M code if documentation supports distinct services provided during the office visit. This means that the insertion procedure is separate from the counseling or diagnosis evaluation.

No. The IUD itself must be billed separately with an appropriate supply code. CPT 58300 covers only the insertion of intrauterine device services, not the device.

Yes, if a new IUD is placed. Use 58301 for removal if both are performed in the same visit. Ensure the visit date, modifier, and documentation are properly maintained and linked to the patient’s chart for accurate claims processing.