HCPCS Code J7298: Levonorgestrel-Releasing Intrauterine Contraceptive System (Mirena), 52 mg

Learn about the HCPCS code J7298 for "Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg."

## **What is the J7298 for?** The HCPCS code J7298 is meant to designate the provision of an intrauterine contraceptive system (Mirena) that releases levonorgestrel, specifically 52 mg of it. This is an intrauterine contraceptive that is placed in the uterus via an IUD insertion procedure. It serves as a long-acting reversible contraceptive (LARC) that gradually releases levonorgestrel over time, and it'll last up to 5 years. Not only does it prevent pregnancy, it can also be used to manage heavy menstrual bleeding (menorrhagia), as well as address prophylaxis for hyperplasia during estrogen replacement therapy. Please note this is not the same as the Liletta brand, and this code only covers the provision of the IUD, not the insertion of it.

## **Documentation requirements for J7298** As with any HCPCS code, it's important that you have sufficient documentation for J7298 that follows your insurer's coding guidelines and requirements, including any related policy articles and local coverage determinations that apply to you (e.g., long-lasting reversible contraception (LARC) quick coding guides. Here are examples of what you need: - The full name of the patient - The full names and credentials of the professionals handling the patient - The relevant information and indications concerning the patient (e.g., contraception, heavy menstrual bleeding, etc.) to justify medical necessity - The name and address of the place of service, plus the type of place of service (e.g., physician office, outpatient clinic, federally qualified health center (FQHC), rural health clinic (RHC), etc.) - Documentation of an encounter for initial prescription of the LARC - The signed provider order for the device - Patient consent for IUD placement - Device information (name and brand, lot number, manufacturer, expiration date) - Any relevant test results/assessments concerning the patient's uterus (if it's meant to address anything other than contraception), like pelvic examinations and ultrasounds

## **Billing requirements for J7298** Besides the documentation requirements above, it's best to take note of or have the following: - 1 IUD = 1 unit - Please have the relevant ICD codes for your patient (e.g. Z30.430 - Encounter for insertion of intrauterine contraceptive device; Z30.433 - Encounter for removal and reinsertion of intrauterine contraceptive device; N92.0 - Excessive and frequent menstruation with regular cycle) - Remember that this code is just for the provision of the IUD, not the insertion or removal. Please use the appropriate CPT code based on what did: 58300 for the insertion of the IUD, or 58301 for the removal

## **Other similar codes** - **J7302** - Levonorgestrel-releasing intrauterine contraceptive system, 52 mg - **J7297** - Levonorgestrel-releasing intrauterine contraceptive system (liletta), 52 mg - **J7301** - Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg - **J7296** - Levonorgestrel-releasing intrauterine contraceptive system, (kyleena), 19.5 mg - **Q9984** - Levonorgestrel-releasing intrauterine contraceptive system (kyleena), 19.5 mg

Frequently asked questions

The patient must be a woman of childbearing age. They must also not have any current pelvic infections. They also must not have any history of uterine abnormalities.

During the insertion procedure, it's possible for the patient to feel cramps, pressure, and discomfort. After the procedure, they might have to deal with spotting and cramps. Over-the-counter or prescription medications for pain relief will help manage it.

Copper IUDs, hormonal patches, hormonal injections, oral contraceptive pills, condoms, and diaphragms.