With these factors in mind, the costs of Implanon without any insurance, from what we researched online, often was in the $600 to $850+ range for both the exam and implant and another $300 to $500~ to have it removed in the future. Again, these are price estimates for those who have no insurance coverage.
To make sure Implanon is safe for you, tell your doctor if you have:
Your General Practitioner or local Family Planning Clinic will be able to remove the Implanon device. Health care practitioners need to be trained in the removal of Implanon and although it is not a complex procedure, this still requires a degree of skill.
TRICARE covers the insertion, removal, and replacement of an intrauterine device (IUD) under the medical benefit. The IUD must be approved by the U.S. Food and Drug Administration and for its intended use. Learn more about Birth Control.
The insertion and/or removal of the implant are reported using one of the following CPT (Current Procedural Terminology) codes:11981 Insertion, non-biodegradable drug delivery implant.11982 Removal, non-biodegradable drug delivery implant.11983 Removal with reinsertion, non-biodegradable drug delivery implant.
11982Possible billing codes for NEXPLANONPossible CPT ® Administration CodesDefinition11981Insertion, non-biodegradable drug delivery implant.11982Removal, non-biodegradable drug delivery implant.11983Removal, with reinsertion, non-biodegradable drug delivery implant.
ForwardHealth continues to reimburse providers for CPT procedure code 11976 (Removal, implantable contraceptive capsules) for the removal of implants such as Norplant.
V45.52V45. 52 - Presence of subdermal contraceptive implant. ICD-10-CM.
Z30.433Z30. 433 Encounter for removal and reinsertion of intrauterine contraceptive device in ICD-10-CM.
Long term (current) use of hormonal contraceptives Z79. 3 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z79. 3 became effective on October 1, 2021.
IUD Removal and Reinsertion It is essential that you code and bill BOTH the CPT code 58301 for the IUD removal and 58300 for the IUD reinsertion with a modifier 51 on the second procedure in order to be paid appropriately for the services.
The insertion and/or removal of IUDs are reported using one of the following CPT codes:58300 Insertion of IUD.58301 Removal of IUD.
Encounter for surveillance of other contraceptivesICD-10 code Z30. 49 for Encounter for surveillance of other contraceptives is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
Encounter for surveillance of implantable subdermal contraceptiveICD-10 code Z30. 46 for Encounter for surveillance of implantable subdermal contraceptive is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .
O26.30Retained intrauterine contraceptive device in pregnancy, unspecified trimester. O26. 30 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM O26.
HCPCS code J7307 for Etonogestrel (contraceptive) implant system, including implant and supplies as maintained by CMS falls under Contraceptive Systems.
The 2022 edition of ICD-10-CM Z30.46 became effective on October 1, 2021.
Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00 -Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
NEXPLANON should be removed in the event of a thrombosis. Due to the risk of thromboembolism associated with pregnancy and immediately following delivery, NEXPLANON should not be used prior to 21 days postpartum. Women with a history of thromboembolic disorders should be made aware of the possibility of a recurrence.
After starting NEXPLANON, women are likely to have changes in their menstrual bleeding pattern. These may include changes in frequency, intensity, or duration. Abnormal bleeding should be evaluated as needed to exclude pathologic conditions or pregnancy. In clinical studies of the non-radiopaque etonogestrel implant, reports of changes in bleeding pattern were the most common reason for stopping treatment (11.1%). Women should be counseled regarding bleeding pattern changes that they may experience.
NEXPLANON is indicated for use by women to prevent pregnancy.
Broken or Bent Implant. There have been reports of broken or bent implants, which may be related to external forces (e.g., manipulation of the implant or contact sports) while in the patient’s arm. There have also been reports of migration of a broken implant fragment within the arm.
Counsel women to contact their health care provider immediately if, at any time, they are unable to palpate the implant.
Implant removal may be difficult or impossible if the implant is not inserted correctly, inserted too deeply, not palpable, encased in fibrous tissue, or has migrated. If at any time the implant cannot be palpated, it should be localized and removal is recommended.
Diagnosis codes should be selected only by a health care professional, and should appropriately reflect the diagnosis, the services rendered, and the applicable payer’s guidelines.
The diagnostic coding will vary, but usually will be selected from the Encounter for Contraceptive Management code series - V25 in ICD-9-CM or Z30 in ICD-10-CM. These codes are:
Note: ICD-10 codes are scheduled to go into effect October 1, 2015. They may not be reported prior to effective date.
J7297 Levonorgestrel-releasing intrauterine contraceptive system, 52 mg, 3 year duration (Begin use of J7297 on January 1, 2015)
V25.11 Insertion of intrauterine contraceptive device or
A modifier 25 (significant, separately identifiable E/M service on the same day as a procedure or other service) is added to the E/M code to indicate that this service was significant and separately identifiable from the insertion. This indicates that two distinct services were provided: an E/M service and a procedure.
For example, if an established patient is seen for 25 minutes, including 15 minutes spent counseling, report code 99214—this code lists a “typical time” of 25 minutes. The level of history, physical examination, and medical decision making do not matter in selecting this code. Not all payers recognize time spent counseling. Providers should consult third-party payers before instituting this coding practice to ensure compliance with specific plan guidelines.
If discussion of contraceptive options takes place during the same encounter as a procedure, such as insertion of a contraceptive implant or IUD, it may or may not be appropriate to report both an E/M services code and the procedure code: