Are you receiving incomplete payments because you don’t know the difference between the IUD device and device insertion codes? Let us help you with one of those! Contraceptives are a modern wonder, allowing women to control their reproductive health. If we talk about numbers, around 82% of women of reproductive age (15 to 49) used one type of birth control in the U.S. in 2024.
IUDs are the third most common contraception among American women. However, many healthcare providers, usually OBGYNs, still struggle with the coding despite performing the procedure regularly. That’s why today, we are discussing CPT code 58300 so you can use it appropriately.
CPT Code 58300 – Description
CPT code 58300 falls within introductory procedures on the corpus uteri (the body of the uterus). It refers to a long-acting reversible contraception (LARC), intrauterine device (IUD) insertion, which is a small, T-shaped device. Don’t confuse this code with HCPCS code S4989 (a separate code for billing IUD devices).
Therefore, CPT code 58300 covers the insertion of an IUD into the patient’s uterine cavity (space inside the uterus) and not the device itself. The primary purpose of this procedure? To prevent pregnancy for several years, depending on the device type.
In short, healthcare providers use CPT code 58300 to report the placement of either:
- A hormonal (Mirena, Kyleena, etc.), or
- A copper (Paragard) birth control device.
Scenarios Where CPT Code 58300 is Applicable
Is the description insufficient? Let us help you understand the correct application of CPT code 58300 with three practical examples.
First-Time IUD Insertion
According to the U.S. Centers for Disease Control and Prevention (CDC), 10.4% of women rely on long-acting reversible contraception to prevent pregnancies. So, for our first scenario, let’s envision a 26-year-old woman seeking long-term birth control.
She visits a renowned gynecologist in her area with her case. Before moving on to contraceptive options, the gynecologist conducts a thorough evaluation and learns that the woman is nulliparous (has never given birth before).
After discussing all the possibilities, he inserts a copper-based IUD into the patient’s uterine cavity upon her request. The gynecologist then reports this procedure using CPT code 58300.
Postpartum IUD Insertion
Did you know that LARC is a popular contraceptive choice among parous women (women who have previously given birth)? Therefore, for our next example, let’s consider a simple scenario.
Suppose a 28-year-old woman visits her gynecologist for a postpartum follow-up after 2 weeks of vaginal delivery. She is seeking a contraceptive solution that will last 3 to 4 years, as she wants to give all her attention to her newborn.
After a brief consultation, the doctor informs her that the procedure is only possible after 6 weeks of birth to reduce the risk of IUD expulsion. Therefore, the patient returns after four weeks. The OBGYN then places a hormone-based IUD in her uterine cavity and uses CPT code 58300 to bill the procedure.
IUD Re-Insertion
Did you know that IUD expulsions are quite common in younger women, especially those under the age of 20?
So, for our last example, let’s suppose an 18-year-old teen visits a gynecologist for an IUD replacement. Upon evaluation, the doctor learns that her device fell out of her uterus two weeks after insertion. The primary reason? Her small uterus.
The OBGYN conducts a physical examination to check for infection or trauma. After finding none, she inserts a new IUD into the patient’s uterine cavity. The billing team then reports this re-insertion with CPT code 58300.
Applicable Modifiers for CPT Code 58300
So, which modifiers can you use with this IUD insertion code? Incorrect use of modifiers can lead to scrutiny or even audit risks. Therefore, you should append appropriate modifiers to CPT code 58300 to avoid these consequences. You can use the following modifiers with this code:
Modifier 51
Remember that there are only two codes for IUD procedures: 58301 (IUD removal) and 58300 (IUD insertion). These procedures are usually performed on the same day on the same patient to maintain continuous contraception.
If you have conducted both IUD removal and insertion on the same day, report CPT code 58300 with modifier 51. This modifier is essential for notifying payers about multiple procedures within the same session.
Modifier 53
IUD insertion can be quite challenging in some cases, mainly due to anatomical factors like uterine fibroids or a narrow cervical canal. So, if you discontinued the procedure for this reason or any other extenuating circumstances, apply modifier 53 to CPT code 58300.
However, keep one thing in mind! You can only use this modifier if you abandoned the IUD insertion procedure after anesthesia administration.
Modifier 59
Append modifier 59 to CPT code 58300 if it is distinct from other services you have performed on the same day on the same patient. This modifier helps identify those services or procedures not normally reported together.
Modifier GY
Medicare does not cover contraceptive devices. Therefore, if your patient is a Medicare beneficiary, apply modifier GY to CPT code 58300 to indicate that it is a non-covered service and trigger an auto-denial.
CPT Code 58300 – Billing & Reimbursement Guidelines
Is it possible to receive maximum reimbursements for CPT code 58300? The answer is right in front of you! Follow our billing and reimbursement tips for this code to avoid claim denials and payment delays.
Don’t Confuse CPT 58300 with an IUD Device’s Code
As we mentioned in the description, CPT code 58300 does not cover the IUD device. It only refers to its insertion. Therefore, use it only when you have placed the birth control device in the patient’s uterine cavity. To bill for the IUD devices, use the appropriate HCPCS codes.
Use 58300 for IUD Insertion Only
Avoid the common mistake of using CPT code 58300 for IUD removal. This code only covers the placement of an intrauterine device. You can report the removal with CPT code 58301.
Use Appropriate Modifiers
If the situation calls for it, use appropriate modifiers with CPT code 58300 to provide additional context. You can find several applicable modifiers in the section above.
Document the IUD Insertion Procedure
Record the key details in the patient’s medical record to avoid claim denials. Those include:
- Written consent for the IUD
- Type of device (hormonal or copper-based)
- Lifespan (depends on the brand)
- Type of insertion method
- Appropriate ICD-10-CM code (e.g., Z30.430)
- Any complications or risks
Maintain Compliance with Payer Rules
As mentioned in the modifier section, Medicare does not cover CPT code 58300. However, some commercial payers do. Therefore, review their coverage policies before filing any claim for this code to avoid potential denials.
Summary
So, what’s your takeaway from our blog? To summarize, CPT code 58300 covers the third most common contraceptive method, IUD insertion. Although intrauterine device procedures only have two CPT codes, many healthcare providers and even billing professionals make common coding mistakes.
We have tried to help you to some extent by providing a simplified description of this code. We have also mentioned three real-life applicable scenarios, emphasizing the correct use of this code. To help you file a clean claim, we have included the smallest details in our guide, such as appropriate modifiers with CPT code 58300 and documentation tips.We hope you now understand the billing part of IUD insertion. But if it still feels complicated, we recommend partnering with an expert. Many third-party billing companies offer OBGYN billing services. The trick is to find the one that aligns with your requirements.
