2025 HCPCS code J7298
(Active) Effective Date: N/A Revision Date: N/A Drugs - Contraceptive Systems J Codes: Drugs Administered Other than Oral Method Feed
Levonorgestrel-releasing intrauterine system (Mirena), 52 mg
Modifiers may be applicable in certain situations. For example, if the procedure is discontinued before completion, modifier 53 may be appropriate.
Medical necessity for the Mirena IUD is based on the patient's need for contraception.This could include a desire to prevent pregnancy, or to manage other conditions like heavy menstrual bleeding. Documentation should support the decision for Mirena over other contraceptive methods.
The clinician is responsible for supplying the Mirena device to the patient. This includes counseling the patient on the risks and benefits of the device, ensuring the patient is a suitable candidate, and providing instructions for follow-up care.It does not typically include insertion, which may be billed separately.
- J Codes: Drugs Administered Other than Oral Method
- J0120-J8999: Drugs Administered Other than Oral Method; J7294-J7307: Contraceptive Systems
In simple words: This code covers the Mirena IUD birth control device, which is placed in the uterus and releases a hormone to prevent pregnancy.It does not cover the insertion procedure itself.
This code represents the supply of one Mirena® contraceptive device, which contains 52 mg of levonorgestrel. It does not include the cost of insertion. The device is placed in the uterus and releases levonorgestrel, a synthetic progestin, to prevent pregnancy.
Example 1: A 25-year-old woman requests a long-term, reversible contraceptive method. After discussing her options with her physician, she chooses the Mirena IUD. The physician provides her with the device, and a separate appointment is scheduled for insertion., A 32-year-old woman with heavy menstrual bleeding wants to use the Mirena IUD for both contraception and to manage her bleeding. Her physician provides the device, which will be inserted at a later date., A patient is switched from another IUD to Mirena. The physician provides her with the new IUD.
Documentation should include the patient's medical history, discussion of contraceptive options, consent for the device, and the provision of the Mirena device itself. The lot number and expiration date of the device should be documented. A separate note should be made if and when the device is inserted.
** J codes are used to report drugs that are not self-administered, chemotherapy drugs, inhalation solutions, and other miscellaneous drugs. This code specifically refers to the Mirena brand of levonorgestrel-releasing intrauterine system.
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Family Medicine
- Place of Service:Office, Clinic, Outpatient Hospital, Inpatient Hospital (if provided during inpatient stay)