Claims Processing for IUDs, Mirena and Other Contraceptive Devices
Attention OB-GYN providers:
Please be advised that claims for the insertion and removal of IUDs, Mirena and other contraceptive devices are to adhere to the following rules:
- All claims/invoices are to be accompanied by a CMS 1500 or UB04 form or they will be denied.
- The HCPCS code to bill for the IUD Mirena is J7298.
For all other IUDs and covered contraceptive devices, Horizon NJ Health will provide payment as follows:
- 85 percent of the AWP (average wholesale price) of the attached invoice.
- Reimbursements for this code will not exceed the plan maximum.
Thank you for your cooperation.