Billing for Nexplanon Implants - Long Acting Reversible Contraceptives (LARCs)

Tuesday, October 1, 2019

Effective Oct. 1, 2019, two additional ICD-10 codes will be added to the LARC DRG reimbursement retroactive date of Oct. 1, 2018.  

Providers must bill with the following HCPCS code, and the appropriate ICD-10 PCS code on the inpatient hospital claim to receive the LARC DRG reimbursement.

HCPCS           Device

J7307              Nexplanon ®

ICD-10-PCS codes:

  • OJHD3HZ Insertion of Contraceptive Device into Right Upper Arm
  • OJHF3HZ. Insertion of Contraceptive Device into Left Upper Arm

Providers may resubmit claims with dates of service on or after Oct. 1, 2018 to receive the appropriate reimbursement. 

For additional information regarding reimbursement of  Long Acting Reversible Contraceptives (LARCS), refer to the January 2019 Medicaid Special Bulletin

Author: 
GDIT, (800) 688-6696