{"id":159074,"date":"2026-07-20T10:19:50","date_gmt":"2026-07-20T10:19:50","guid":{"rendered":"https:\/\/pabau.com\/?p=159074"},"modified":"2026-08-13T12:06:01","modified_gmt":"2026-08-13T12:06:01","slug":"hcpcs-code-j7298","status":"publish","type":"post","link":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/","title":{"rendered":"HCPCS Code J7298: Levonorgestrel IUD billing, Medicare, and claims"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"HCPCS Code J7298: Levonorgestrel IUD billing, Medicare, and documentation\",\"description\":\"HCPCS Code J7298 (levonorgestrel-releasing intrauterine system, 52 mg) billing guide covering Mirena, Liletta, CPT pairings, ICD-10 codes, Medicare reimbursement, and common claim errors.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j7298\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-07-14\",\"dateModified\":\"2026-07-14\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key Takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key Takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>HCPCS Code J7298 is the brand-specific code for Mirena (Bayer), a 52 mg levonorgestrel-releasing IUD; Liletta bills under its own code, J7297, not J7298<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Bill one unit of J7298 per device supplied; pair it with CPT 58300 for insertion \u2014 the same code applies whether or not hysteroscopic guidance is used, since there\u2019s no dedicated hysteroscopic-guided IUD placement code<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Medicare Part B reimbursement is based on ASP+6%; rates change quarterly and must be verified against the current CMS ASP file before billing<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Pabau&#8217;s claims management software helps OB\/GYN and family practice teams submit J7298 claims with accurate unit counts, modifiers, and paired CPT codes<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">HCPCS Code J7298: definition and clinical descriptor<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">HCPCS Code J7298 is the billable code for Mirena, the 52 mg levonorgestrel-releasing intrauterine system from Bayer. It&#8217;s brand-specific: Liletta, Kyleena, and Skyla each bill under their own code (J7297, J7296, and J7301). Four distinct levonorgestrel IUD HCPCS codes are active today, and selecting the wrong one for the device dispensed triggers an NDC mismatch that payers catch immediately.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This reference guide covers the full J7298 descriptor, the brand devices it covers, paired CPT and ICD-10 codes, Medicare and Medicaid reimbursement rules, and the documentation that must accompany every claim. For a broader look at HCPCS Level II coding patterns.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">J7298 code details at a glance<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The table below summarizes the core fields coders and billers need before submitting any claim containing HCPCS Code J7298.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">HCPCS Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">J7298<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Full descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Levonorgestrel-releasing intrauterine contraceptive system, 52 mg (Mirena)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Drug class<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Intrauterine contraceptive \/ progestogen-releasing system<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Brand devices covered<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mirena (Bayer) only<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Unit definition<\/td>\n<td style=\"padding:12px 16px;color:#374151\">1 unit = 1 device (52 mg system)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code category<\/td>\n<td style=\"padding:12px 16px;color:#374151\">HCPCS Level II, J-code (drugs and biologicals)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Maintaining body<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CMS (Centers for Medicare and Medicaid Services)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Verify the current descriptor wording against the <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/healthcare-common-procedure-system\" target=\"_blank\" rel=\"nofollow noopener\">CMS HCPCS overview<\/a> before each billing year. CMS publishes annual updates that occasionally revise descriptor language or dosage labeling.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What drugs and devices does J7298 cover?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">HCPCS Code J7298 is brand-specific: it maps only to Mirena, the 52 mg levonorgestrel-releasing IUD from Bayer. CMS dropped duration language from the J7298 descriptor in a 2017 revision, so the code is no longer tied to a labeled duration \u2014 it\u2019s tied to the brand and dose.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Mirena (Bayer):<\/strong> The only device that maps to J7298. FDA-approved for up to 8 years of use for contraception and up to 5 years for heavy menstrual bleeding.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The current HCPCS descriptor is brand-specific rather than duration-based \u2014 CMS removed the duration language from J7298 in the 2017 revision. Verify Mirena&#8217;s current NDC against the CMS NDC-to-HCPCS crosswalk file before each claim, as Bayer periodically updates packaging NDC numbers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Liletta (Medicines360, marketed by Allergan\/AbbVie):<\/strong> A separate 52 mg levonorgestrel IUD approved for up to 8 years. Liletta does not map to J7298 \u2014 it bills under its own code, J7297.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Coders should confirm the specific Liletta NDC against the current CMS crosswalk file before submitting a J7297 claim. Practices managing device inventory can use <a href=\"https:\/\/pabau.com\/features\/inventory-management-software\/\">inventory management software<\/a> that ties lot numbers to dispensed NDCs automatically.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Mirena is an FDA-regulated device, and clinical claims about its approved indications must match current FDA prescribing information, not prior label versions.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Mirena should never be billed under a code intended for a different brand or dose \u2014 J7296 (Kyleena), J7297 (Liletta), or J7301 (Skyla) \u2014 regardless of how many years of use remain on the device at the time of insertion.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Brand<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Manufacturer<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Dose<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">HCPCS code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">NDC verification required<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Mirena<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bayer<\/td>\n<td style=\"padding:12px 16px;color:#374151\">52 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">J7298<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes, annual crosswalk check<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Liletta<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicines360 (marketed by Allergan\/AbbVie)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">52 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">J7297<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes, confirm per lot number<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\">How to bill HCPCS J7298: step-by-step<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">J7298 is a supply code, not a procedure code. It reimburses the device itself. The insertion procedure is billed separately on the same claim using a paired CPT code. Submitting J7298 without the CPT insertion code is one of the most common reasons for denial on IUD claims.<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Select the appropriate CPT code for the procedure.<\/strong> Choose from the CPT codes in the table below based on how and where the IUD was placed.<\/li><li><strong>Attach J7298 as a separate line on the claim.<\/strong> Bill one unit per device supplied. Never bill two units for a single IUD insertion.<\/li><li><strong>Assign the supporting ICD-10-CM diagnosis code.<\/strong> The diagnosis code must confirm the clinical reason for contraceptive device placement.<\/li><li><strong>Add the National Drug Code (NDC) in the qualifier field.<\/strong> Report the 11-digit NDC for the specific Mirena or Liletta lot dispensed. Format: N4 qualifier + 11-digit NDC + unit of measure qualifier (UN) + quantity (1).<\/li><li><strong>Set the place of service (POS) code.<\/strong> POS 11 (office) is standard for in-office insertion. POS 22 (outpatient hospital) or POS 19 (off-campus outpatient) applies when performed at a facility.<\/li><li><strong>Submit the claim.<\/strong> Run eligibility and benefit verification before submission. Confirm the patient&#8217;s contraceptive benefit, any prior authorization requirement, and applicable deductible or copay structure.<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Practices using claims management software can build claim templates that pre-populate J7298 with its paired CPT, default POS, and NDC qualifier fields, reducing manual entry errors on every IUD claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pairing this with automated billing workflows means staff are prompted to capture the NDC at the point of dispensing rather than reconstructing it from memory at the time of claim submission.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/hcpcs-code-j7298\/track-claims-from-start-to-finish.webp\" alt=\"Track claims from start to Finish\"\/><figcaption class=\"wp-element-caption\"><em>Track claims from start to Finish<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 class=\"wp-block-heading\">CPT codes paired with J7298<\/h3>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Descriptor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">58300<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Insertion of intrauterine device (IUD)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Standard insertion, including hysteroscopic-guided placement<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">58301<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Removal of intrauterine device (IUD)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Removal without same-session reinsertion<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 58565 is sometimes mistaken for a hysteroscopic IUD placement code, but its actual descriptor covers hysteroscopic bilateral fallopian tube occlusion \u2014 the Essure sterilization procedure \u2014 not IUD insertion. Standard IUD placement bills under CPT 58300 regardless of whether hysteroscopic guidance is used; there is no dedicated CPT code for hysteroscopic-guided IUD placement.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Do not bill CPT 58301 (removal) and J7298 (supply) on the same date unless the procedure includes immediate reinsertion. Removal-only encounters do not use a supply code. Confirm pairing rules with the current AMA CPT codebook and payer-specific policies, as commercial payers occasionally have bundling edits that differ from Medicare guidelines.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">ICD-10 diagnosis codes used with J7298<\/h3>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Common use context<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z30.430<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Encounter for insertion of intrauterine contraceptive device<\/td>\n<td style=\"padding:12px 16px;color:#374151\">First insertion, no prior IUD history<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z30.431<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Encounter for routine checking of intrauterine contraceptive device<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Follow-up visits to confirm device position<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z30.432<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Encounter for removal of intrauterine contraceptive device<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Removal-only encounters<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Z30.433<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Encounter for removal and reinsertion of intrauterine contraceptive device<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same-session removal and new device insertion<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">N92.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Excessive and frequent menstruation with regular cycle<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Heavy menstrual bleeding indication for Mirena<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Practices serving patients with reproductive health needs can link ICD-10 code assignment to treatment records in sexual health clinic software, reducing the risk of a mismatched diagnosis on claims for hormonal contraceptive devices. Some of these same practices also bill related obstetric codes.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Simplify IUD billing from device supply to claim submission                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&#8217;s claims management tools help OB\/GYN and family practice teams attach the right HCPCS supply codes, NDC qualifiers, and paired CPT codes on every claim, so J7298 submissions go out clean the first time.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management for OB\/GYN billing\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 class=\"wp-block-heading\">Medicare and Medicaid reimbursement for J7298<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare Part B covers J7298 when the levonorgestrel-releasing IUD is furnished incident to a physician service in an appropriate outpatient setting. Coverage is subject to applicable Local Coverage Determinations issued by the Medicare Administrative Contractor responsible for the practice&#8217;s jurisdiction. Verify the relevant LCD before billing, as coverage criteria and documentation requirements vary by MAC region.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare reimbursement for Part B drugs follows the average sales price (ASP) methodology. The standard payment formula is ASP plus 6 percent.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Because ASP rates are updated quarterly by CMS, never publish or use a specific dollar figure for J7298 reimbursement without pulling the current quarter&#8217;s ASP pricing file from the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">Physician Fee Schedule lookup<\/a>. A rate that was accurate last quarter may already be outdated.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Payer<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Payment methodology<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Prior authorization<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicare Part B<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ASP + 6% (quarterly update)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subject to MAC LCD<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Verify current ASP file each quarter<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicaid<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Varies by state<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Varies by state<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Most states cover contraceptive IUDs; confirm state fee schedule<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Commercial payers<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Contracted rate or fee schedule<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Plan-dependent<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Verify PA requirements per payer contract<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Medicaid coverage for HCPCS Code J7298 is nearly universal across states for contraceptive indications, but reimbursement rates, formulary requirements, and prior authorization rules differ significantly by state program. Never apply Medicare&#8217;s ASP rate logic to Medicaid claims. Pull the applicable state Medicaid fee schedule directly from the state agency&#8217;s provider portal.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">J7296 vs J7297 vs J7298 vs J7301: key differences<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Four levonorgestrel IUD HCPCS codes are billed today, each tied to a specific brand and dose: J7296 (Kyleena), J7297 (Liletta), J7298 (Mirena), and J7301 (Skyla). A fifth code, J7302, is a non-brand-specific 52 mg descriptor that multiple coding references flag as deleted or inactive, so don&#8217;t rely on it as a current, reliable billable code. Deleted or replaced codes turn up elsewhere in HCPCS too .<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Selecting the wrong code for the brand and dose dispensed is one of the most common HCPCS billing errors in reproductive health practices. The comparison below clarifies which code applies to each device.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">HCPCS code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Brand device<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Manufacturer<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Dose<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key differentiator<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J7296<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Kyleena<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bayer<\/td>\n<td style=\"padding:12px 16px;color:#374151\">19.5 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Lowest effective dose in the levonorgestrel range; contraception only, smaller frame<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J7297<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Liletta<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicines360 (marketed by Allergan\/AbbVie)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">52 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same dose as Mirena, billed under its own brand-specific code<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J7298<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mirena<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bayer<\/td>\n<td style=\"padding:12px 16px;color:#374151\">52 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Approved for contraception and heavy menstrual bleeding<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J7301<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Skyla<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bayer<\/td>\n<td style=\"padding:12px 16px;color:#374151\">13.5 mg<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Lowest-dose tier; smallest frame, often used in nulliparous patients<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The critical rule: always bill the HCPCS code that matches the brand and dosage actually dispensed. A Mirena inserted but billed as J7301 will likely pass through automated edits initially but fail on audit when the NDC number is traced back to a 52 mg device.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The reverse error \u2014 billing J7298 for a 13.5 mg Skyla insertion \u2014 is a higher-dollar overpayment that triggers recoupment. Confirm the device dispensed, verify the NDC, then select the matching code.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Audit your IUD claim templates quarterly. Pull all claims billed with J7296, J7297, J7298, and J7301 from the previous 90 days and cross-reference each CPT line against the HCPCS supply code. Flag any claim still billed under J7302 for correction, since CMS and multiple coding references list it as deleted or inactive. Any claim with J7298 paired to a CPT for a different procedure, or missing an NDC qualifier, should be corrected before the 12-month timely filing window closes.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Common billing errors with J7298 and how to avoid them<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">IUD supply code claims have a narrow margin for error. Payers run automated claim edits that flag unit quantity mismatches, NDC omissions, and CPT pairing issues before a human reviewer ever sees the claim. These are the denial patterns that appear most often on J7298 submissions.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Wrong unit quantity.<\/strong> Bill 1 unit per device. Two units on a single-device insertion claim will be denied automatically. The only scenario where a second J7298 unit might be justified is immediate replacement of an expelled device on the same date of service, and even then, documentation must clearly support both events.<\/li><li><strong>Missing or incorrectly formatted NDC.<\/strong> The NDC qualifier (N4), the 11-digit NDC, the unit of measure (UN), and the quantity (1) must all appear in the correct fields. An NDC reported without the qualifier or in the wrong format causes rejection at the clearinghouse level before the claim reaches the payer.<\/li><li><strong>Wrong HCPCS code for the device supplied.<\/strong> A Kyleena (19.5 mg, billed under J7296) submitted as J7298 will create a brand-and-dose mismatch when the NDC is traced. Use the crosswalk-verified code for the actual device dispensed.<\/li><li><strong>Unbundled CPT and HCPCS lines.<\/strong> Some payers require both the CPT insertion code and J7298 on the same claim. Submitting J7298 on a claim without a paired CPT insertion code results in denial for missing procedure context.<\/li><li><strong>Place of service mismatch.<\/strong> If the IUD was inserted in a hospital outpatient department, POS 11 (office) is incorrect. Using the wrong POS triggers a site-of-service differential that can result in either underpayment or a technical denial.<\/li><li><strong>Absent prior authorization for commercial payers.<\/strong> Many commercial plans require PA for IUD supply codes. Submitting without authorization results in a denial that is difficult to overturn post-service. Verify PA requirements before insertion, not after.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Catching these at the pre-submission stage costs a fraction of the time and staff effort required to work a denial.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Documentation requirements for J7298 claims<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CMS and commercial payers require specific documentation to support each element of a J7298 claim. Missing documentation does not just create audit risk; it directly supports or undermines the clinical medical necessity argument if a claim is reviewed or audited. Similar documentation standards apply across other HCPCS supply codes.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Brand name and NDC of the device dispensed.<\/strong> The medical record must identify the specific device used. &#8222;Mirena IUD inserted&#8220; is not sufficient. The entry should include &#8222;Mirena, 52 mg levonorgestrel-releasing intrauterine system, NDC [11-digit number], lot number [lot], expiration date [date] inserted.&#8220;<\/li><li><strong>Date of service.<\/strong> The insertion date must match the date on the claim. Date discrepancies between the clinical note and the claim form are a common audit finding.<\/li><li><strong>Clinical indication.<\/strong> The note must document the clinical reason for insertion. For contraceptive indications, this means documenting the patient&#8217;s choice of contraceptive method and confirmation of no contraindications. For heavy menstrual bleeding, document the HMB diagnosis and failed or declined alternatives.<\/li><li><strong>Informed consent.<\/strong> Document that the patient received counseling on the device, its risks, benefits, and alternatives, and that written informed consent was obtained.<\/li><li><strong>Procedure note.<\/strong> The clinical note must describe the insertion procedure: patient positioning, speculum placement, uterine sounding, device placement, and confirmation of proper position. For Mirena and Liletta, document thread visibility post-insertion.<\/li><li><strong>Modifier documentation (where applicable).<\/strong> If a modifier is applied (for example, a bilateral or multiple-procedure modifier), the record must support the modifier&#8217;s use. Modifier requirements vary by payer.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Practices using clinical documentation software with structured note templates can embed these required fields directly into their IUD insertion note template. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices managing controlled substance or hormonal prescriptions alongside IUD insertions may also benefit from structured prescription management workflows that tie prescription records to the corresponding clinical note.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">HIPAA-compliant documentation storage is a requirement for all clinical records supporting J7298 claims. For a practical overview of documentation and storage compliance obligations.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related HCPCS codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j7030-normal-saline-infusion\/\">HCPCS code J7030 \u2014 Normal Saline Infusion<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j7307\/\">HCPCS code J7307 explained \u2014 Contraceptive implant<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j7308\/\">HCPCS Code J7308 \u2014 Aminolevulinic acid HCl<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j7312\/\">HCPCS code J7312 \u2014 Dexamethasone Intravitreal Implant<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">HCPCS Code J7298 claims fail most often for reasons that are entirely preventable: wrong dosage code, missing NDC qualifier, mismatched POS, or no paired CPT. Every one of those errors is a process fix, not a clinical one.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&#8217;s claims management software helps OB\/GYN and family practice teams build claim templates that enforce correct HCPCS supply code selection, NDC formatting, and CPT pairings at the point of charge capture, before a claim reaches the payer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Combine that with Insights Plus, Pabau&#8217;s add-on for deeper billing analytics and reporting, to track denial patterns across J-codes and spot recurring errors early. To see how Pabau handles reproductive health billing workflows end to end, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a>.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need to see how another reproductive health diagnosis is billed?<\/strong> ICD-10 code <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-n853\/\">O90.89<\/a> covers postpartum subinvolution of uterus, a common follow-up diagnosis after delivery.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Want another example of a deleted HCPCS code and its replacement?<\/strong> HCPCS <a href=\"https:\/\/pabau.com\/procedure-codes\/hcpcs-code-j1040\/\">J1040<\/a> walks through a discontinued methylprednisolone acetate code and the successor billers should use instead.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Supporting a patient through a VBAC delivery?<\/strong> Pabau&#8217;s <a href=\"https:\/\/pabau.com\/templates\/vbac-birth-plan\/\">VBAC birth plan template<\/a> gives practices a structured document for vaginal birth after cesarean planning.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1784537537535\"><h3 class=\"schema-faq-question\">What does HCPCS Code J7298 cover?<\/h3> <p class=\"schema-faq-answer\">HCPCS Code J7298 covers the levonorgestrel-releasing intrauterine contraceptive system at the 52 mg dose \u2014 specifically Mirena (Bayer). The current descriptor is brand-specific rather than duration-based; CMS removed the duration language from J7298 in a 2017 revision. Liletta, a separate 52 mg device, bills under its own code, J7297. J7298 reimburses the device supply only; the insertion procedure is billed separately using a paired CPT code such as 58300.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537537536\"><h3 class=\"schema-faq-question\">What is the difference between J7298 and J7302?<\/h3> <p class=\"schema-faq-answer\">J7298 is the brand-specific code for Mirena, the 52 mg levonorgestrel-releasing IUD from Bayer. J7302 is a non-brand-specific descriptor for a 52 mg levonorgestrel-releasing intrauterine system that multiple coding references flag as deleted or inactive, so it isn&#8217;t a reliable, currently billable code. Bill Mirena under J7298, not J7302.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537537537\"><h3 class=\"schema-faq-question\">Does Medicare cover J7298?<\/h3> <p class=\"schema-faq-answer\">Medicare Part B generally covers J7298 when the device is furnished incident to a physician service in an appropriate outpatient setting. Coverage is subject to the Local Coverage Determination issued by the applicable Medicare Administrative Contractor. Reimbursement is calculated at ASP plus 6 percent, with rates updated quarterly by CMS. Check the relevant MAC LCD and the current CMS ASP pricing file before billing.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537537538\"><h3 class=\"schema-faq-question\">How many units do you bill for J7298?<\/h3> <p class=\"schema-faq-answer\">Bill 1 unit per device supplied. The HCPCS J7298 descriptor defines one unit as one 52 mg levonorgestrel-releasing intrauterine system. Billing more than 1 unit on a standard single-device insertion will result in an automated denial. A second unit may be supported in rare circumstances, such as immediate reinsertion of an expelled device, but requires documentation of both events.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537537539\"><h3 class=\"schema-faq-question\">Is J7298 used for both Mirena and Liletta?<\/h3> <p class=\"schema-faq-answer\">No. J7298 is specific to Mirena (Bayer). Liletta, a separate 52 mg levonorgestrel-releasing IUD from Medicines360 (marketed by Allergan\/AbbVie), bills under its own code, J7297. The two devices aren&#8217;t interchangeable on a claim; billing Liletta under J7298, or Mirena under J7297, creates an NDC-to-HCPCS mismatch that fails on audit.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784537537540\"><h3 class=\"schema-faq-question\">How is J7298 reimbursed under Medicaid?<\/h3> <p class=\"schema-faq-answer\">Medicaid reimbursement for J7298 varies by state. Most state Medicaid programs cover levonorgestrel IUDs for contraceptive indications, but payment rates, prior authorization requirements, and formulary rules differ significantly across programs. Do not apply Medicare&#8217;s ASP rate logic to Medicaid claims. Verify the applicable state Medicaid fee schedule and PA requirements through the state agency&#8217;s provider portal before billing.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>HCPCS Code J7298: definition and clinical descriptor HCPCS Code J7298 is the billable code for Mirena, the 52 mg levonorgestrel-releasing intrauterine system from Bayer. It&#8217;s brand-specific: Liletta, Kyleena, and Skyla each bill under their own code (J7297, J7296, and J7301). Four distinct levonorgestrel IUD HCPCS codes are active today, and selecting the wrong one for [&hellip;]<\/p>\n","protected":false},"author":77,"featured_media":159073,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"86","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1548],"tags":[3466],"class_list":["post-159074","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-hcpcs","tag-contraceptive-device-coding"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>HCPCS Code J7298 for Mirena: Complete Overview<\/title>\n<meta name=\"description\" content=\"J7298 bills only Mirena, the 52 mg levonorgestrel IUD from Bayer \u2014 Liletta uses J7297. See CPT pairs, ICD-10 codes, and Medicare rates.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HCPCS Code J7298 for Mirena: Complete Overview\" \/>\n<meta property=\"og:description\" content=\"J7298 bills only Mirena, the 52 mg levonorgestrel IUD from Bayer \u2014 Liletta uses J7297. See CPT pairs, ICD-10 codes, and Medicare rates.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-07-20T10:19:50+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-13T12:06:01+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/hcpcs-code-j7298.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Katy Piper\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"Verfasst von\" \/>\n\t<meta name=\"twitter:data1\" content=\"Katy Piper\" \/>\n\t<meta name=\"twitter:label2\" content=\"Gesch\u00e4tzte Lesezeit\" \/>\n\t<meta name=\"twitter:data2\" content=\"13\u00a0Minuten\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/\"},\"author\":{\"name\":\"Katy Piper\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/5de22f4ff3ec59b1925ef02dce956d7d\"},\"headline\":\"HCPCS Code J7298: Levonorgestrel IUD billing, Medicare, and claims\",\"datePublished\":\"2026-07-20T10:19:50+00:00\",\"dateModified\":\"2026-08-13T12:06:01+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/\"},\"wordCount\":2652,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/hcpcs-code-j7298.webp\",\"keywords\":[\"Contraceptive Device Coding\"],\"articleSection\":[\"Billing Codes\",\"HCPCS\"],\"inLanguage\":\"de\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/\",\"name\":\"HCPCS Code J7298 for Mirena: Complete Overview\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/hcpcs-code-j7298.webp\",\"datePublished\":\"2026-07-20T10:19:50+00:00\",\"dateModified\":\"2026-08-13T12:06:01+00:00\",\"description\":\"J7298 bills only Mirena, the 52 mg levonorgestrel IUD from Bayer \u2014 Liletta uses J7297. See CPT pairs, ICD-10 codes, and Medicare rates.\",\"mainEntity\":[{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537535\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537536\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537537\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537538\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537539\"},{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537540\"}],\"inLanguage\":\"de\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"de\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#primaryimage\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/hcpcs-code-j7298.webp\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/hcpcs-code-j7298.webp\",\"width\":1200,\"height\":630},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#website\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/\",\"name\":\"Pabau\",\"description\":\"Clinic Software for your Business | Go Paperless Today\",\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/pabau.com\\\/de\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"de\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\",\"name\":\"Pabau\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"de\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2022\\\/05\\\/Logo-4-e1654525062364.png\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2022\\\/05\\\/Logo-4-e1654525062364.png\",\"width\":736,\"height\":195,\"caption\":\"Pabau\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/Pabau\\\/\",\"https:\\\/\\\/x.com\\\/pabaucrm\",\"https:\\\/\\\/www.linkedin.com\\\/company\\\/pabau-ltd\\\/\",\"https:\\\/\\\/www.instagram.com\\\/pabausoftware\\\/\"],\"description\":\"Pabau is an all-in-one healthcare practice management software platform designed for clinics, medspas, therapists, and medical professionals. It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/5de22f4ff3ec59b1925ef02dce956d7d\",\"name\":\"Katy Piper\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"de\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/cropped-Snip20260306_177-96x96.png\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/cropped-Snip20260306_177-96x96.png\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/cropped-Snip20260306_177-96x96.png\",\"caption\":\"Katy Piper\"},\"description\":\"Katy Piper is a content writer covering aesthetics, dermatology, and clinic operations, with a knack for making clinical detail feel approachable. Outside of work, she's usually chasing her border collie around muddy fields or hunting down the best flat white in town.\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/blog\\\/author\\\/katy-piper\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537535\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537535\",\"name\":\"What does HCPCS Code J7298 cover?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"HCPCS Code J7298 covers the levonorgestrel-releasing intrauterine contraceptive system at the 52 mg dose \u2014 specifically Mirena (Bayer). The current descriptor is brand-specific rather than duration-based; CMS removed the duration language from J7298 in a 2017 revision. Liletta, a separate 52 mg device, bills under its own code, J7297. J7298 reimburses the device supply only; the insertion procedure is billed separately using a paired CPT code such as 58300.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537536\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537536\",\"name\":\"What is the difference between J7298 and J7302?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"J7298 is the brand-specific code for Mirena, the 52 mg levonorgestrel-releasing IUD from Bayer. J7302 is a non-brand-specific descriptor for a 52 mg levonorgestrel-releasing intrauterine system that multiple coding references flag as deleted or inactive, so it isn't a reliable, currently billable code. Bill Mirena under J7298, not J7302.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537537\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537537\",\"name\":\"Does Medicare cover J7298?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Medicare Part B generally covers J7298 when the device is furnished incident to a physician service in an appropriate outpatient setting. Coverage is subject to the Local Coverage Determination issued by the applicable Medicare Administrative Contractor. Reimbursement is calculated at ASP plus 6 percent, with rates updated quarterly by CMS. Check the relevant MAC LCD and the current CMS ASP pricing file before billing.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537538\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537538\",\"name\":\"How many units do you bill for J7298?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Bill 1 unit per device supplied. The HCPCS J7298 descriptor defines one unit as one 52 mg levonorgestrel-releasing intrauterine system. Billing more than 1 unit on a standard single-device insertion will result in an automated denial. A second unit may be supported in rare circumstances, such as immediate reinsertion of an expelled device, but requires documentation of both events.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537539\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537539\",\"name\":\"Is J7298 used for both Mirena and Liletta?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. J7298 is specific to Mirena (Bayer). Liletta, a separate 52 mg levonorgestrel-releasing IUD from Medicines360 (marketed by Allergan\\\/AbbVie), bills under its own code, J7297. The two devices aren't interchangeable on a claim; billing Liletta under J7298, or Mirena under J7297, creates an NDC-to-HCPCS mismatch that fails on audit.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537540\",\"position\":6,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/hcpcs-code-j7298\\\/#faq-question-1784537537540\",\"name\":\"How is J7298 reimbursed under Medicaid?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Medicaid reimbursement for J7298 varies by state. Most state Medicaid programs cover levonorgestrel IUDs for contraceptive indications, but payment rates, prior authorization requirements, and formulary rules differ significantly across programs. Do not apply Medicare's ASP rate logic to Medicaid claims. 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Outside of work, she's usually chasing her border collie around muddy fields or hunting down the best flat white in town.","url":"https:\/\/pabau.com\/de\/blog\/author\/katy-piper\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537535","position":1,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537535","name":"What does HCPCS Code J7298 cover?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"HCPCS Code J7298 covers the levonorgestrel-releasing intrauterine contraceptive system at the 52 mg dose \u2014 specifically Mirena (Bayer). The current descriptor is brand-specific rather than duration-based; CMS removed the duration language from J7298 in a 2017 revision. Liletta, a separate 52 mg device, bills under its own code, J7297. J7298 reimburses the device supply only; the insertion procedure is billed separately using a paired CPT code such as 58300.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537536","position":2,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537536","name":"What is the difference between J7298 and J7302?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"J7298 is the brand-specific code for Mirena, the 52 mg levonorgestrel-releasing IUD from Bayer. J7302 is a non-brand-specific descriptor for a 52 mg levonorgestrel-releasing intrauterine system that multiple coding references flag as deleted or inactive, so it isn't a reliable, currently billable code. Bill Mirena under J7298, not J7302.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537537","position":3,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537537","name":"Does Medicare cover J7298?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Medicare Part B generally covers J7298 when the device is furnished incident to a physician service in an appropriate outpatient setting. Coverage is subject to the Local Coverage Determination issued by the applicable Medicare Administrative Contractor. Reimbursement is calculated at ASP plus 6 percent, with rates updated quarterly by CMS. Check the relevant MAC LCD and the current CMS ASP pricing file before billing.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537538","position":4,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537538","name":"How many units do you bill for J7298?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Bill 1 unit per device supplied. The HCPCS J7298 descriptor defines one unit as one 52 mg levonorgestrel-releasing intrauterine system. Billing more than 1 unit on a standard single-device insertion will result in an automated denial. A second unit may be supported in rare circumstances, such as immediate reinsertion of an expelled device, but requires documentation of both events.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537539","position":5,"url":"https:\/\/pabau.com\/de\/procedure-codes\/hcpcs-code-j7298\/#faq-question-1784537537539","name":"Is J7298 used for both Mirena and Liletta?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. J7298 is specific to Mirena (Bayer). Liletta, a separate 52 mg levonorgestrel-releasing IUD from Medicines360 (marketed by Allergan\/AbbVie), bills under its own code, J7297. 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