J7297 Levonorgestrel IUD Reimbursement

HCPCS Level II code J7297 designates the 52 mg levonorgestrel-releasing intrauterine contraceptive system (Liletta). It identifies the device component of a long-acting reversible contraceptive used in outpatient gynecologic and family planning settings. Nationally, accurate use of this HCPCS Level II code supports appropriate device billing, inventory tracking, and policy compliance for contraceptive services that have implications for preventive care access and women's health coverage.

Key payers in the scope of this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the device, where and how the service is typically delivered, and the payer landscape covered. The publication summarizes common billing considerations, typical sites of service, and the payer mix relevant to national reimbursement patterns. It also outlines what readers can expect regarding benchmarks and recent policy updates where available, and directs readers to additional resources for coding, claim submission, and coverage verification.

Data not available in the input is clearly noted where applicable.

Billing Code Overview

HCPCS Level II code J7297 represents the levonorgestrel-releasing intrauterine contraceptive system (Liletta), 52 mg. This code is used to report the device component of a long-acting, reversible contraceptive system that releases levonorgestrel over time to provide intrauterine contraception.

Service Type: Contraceptive device implantation (IUD) — levonorgestrel-releasing intrauterine system

Typical Site of Service: Outpatient ambulatory clinic or office, including gynecology practices and family planning clinics where intrauterine devices are supplied and may be inserted. Data not available in the input.

Clinical Context

A 28-year-old person presents to an ambulatory gynecology clinic requesting long-acting reversible contraception. They have completed counseling about options and select a levonorgestrel-releasing intrauterine system (Liletta, J7297, 52 mg). The patient has a negative pregnancy test and no active pelvic infection. The clinical workflow includes pre-procedure counseling and consent, pregnancy testing, review of cervical infection risk and recent STI screen as indicated, pelvic exam and bimanual exam, placement of the intrauterine device under speculum visualization with sterile technique, post-placement instructions, and scheduling of a follow-up visit (commonly 4–12 weeks) to check threads and address concerns. Typical site of service is an outpatient physician office or ambulatory surgery center. The service type is a contraceptive device insertion and supply of the medication-eluting intrauterine contraceptive system. Common patient scenarios include routine contraception initiation, replacement at end of labeled duration, or replacement for heavy menstrual bleeding management when appropriate.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (standard claim)	Use when no special circumstances apply to the service.

Taxonomy Code	Specialty	Notes
`207Q00000X`	Obstetrics & Gynecology	Gynecologists frequently perform IUD insertions and removals.
`208000000X`	Family Medicine	Family physicians commonly provide contraception services including IUD placement.
`363L00000X`	Nurse Midwife	Certified nurse-midwives perform insertions in many outpatient settings.
`163WH0700X`	Women's Health Nurse Practitioner	Women's health NPs provide counseling and device placement in clinics.
`207V00000X`	Gynecologic Oncology	Occasionally involved if complex pelvic conditions affect device management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z30.430`	Insertion of intrauterine contraceptive device	Directly indicates the reason for the encounter and supports billing for IUD insertion and supply.
`Z30.430`	Encounter for insertion of intrauterine contraceptive device	Used to document routine contraceptive device placement.
`N92.0`	Excessive and frequent menstruation with regular cycle	Levonorgestrel IUS may be used therapeutically for heavy menstrual bleeding management.
`N91.2`	Amenorrhea, unspecified	IUS can cause amenorrhea; may be documented as part of contraceptive counseling or expected effect.
`Z30.49`	Encounter for other contraceptive management	Used when additional contraceptive services or counseling accompany insertion.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`58300`	Insertion of intrauterine device (IUD)	Primary procedure for placement of an intrauterine contraceptive device; performed at the time `J7297` supply when billing separate insertion service.
`58301`	Removal of intrauterine device (IUD)	Performed when the existing device is removed prior to replacement with `J7297` or for device removal for other reasons.
`58301` + `58300` combo	Removal with reinsertion during same encounter (report both codes where supported)	Common workflow when an existing IUD is removed and a new `J7297` device is inserted in the same visit.
`99213`	Office or other outpatient visit for established patient, moderate complexity	Typical E/M code when counseling, consent, and evaluation occur on the same day as device insertion; use `25` modifier when appropriate.
`99070`	Supplies and materials (eg, non-implantable)	Sometimes used by facilities to report additional supply costs; check payer rules regarding device supply reporting.

OpenPayer

Summary & Overview

HCPCS J7297: Levonorgestrel-Releasing Intrauterine Contraceptive System, 52 mg