J7302 Levonorgestrel IUD Reimbursement

HCPCS Level II code J7302 identifies the levonorgestrel-releasing intrauterine contraceptive system, 52 mg — a long-acting reversible contraceptive device used for effective, extended-duration pregnancy prevention. This code is nationally significant because LARC methods like the 52 mg levonorgestrel IUD are widely used across outpatient and office-based gynecologic and family planning services and are a focus of payer coverage policies and public health programs.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for the device, typical sites of service, and the payment and coverage considerations that commonly affect access to LARC devices. The publication outlines common billing patterns, relevant service line implications, and what to expect in payer policies and claims processing for J7302.

The report also summarizes benchmarks and policy updates that influence reimbursement and utilization of LARC devices at a national level. Where data is not provided in the input, the publication indicates the absence of that information rather than inferring specifics. This resource is intended to help coding professionals, billing managers, and policy analysts understand the clinical and administrative context for HCPCS Level II code J7302.

Billing Code Overview

HCPCS Level II code J7302 describes a levonorgestrel-releasing intrauterine contraceptive system, 52 mg. The service type is long-acting reversible contraception (LARC) device placement and provision, which typically involves supply and insertion of the intrauterine system.

Typical site of service is outpatient clinic or physician office, including gynecology and family planning settings where device insertion and follow-up care occur.

Data not available in the input.

Clinical Context

A 29-year-old woman presents to a family planning clinic requesting long-acting reversible contraception. She desires highly effective birth control for at least five years and has no contraindications to intrauterine devices. The clinician reviews medical history, performs a focused gynecologic exam, assesses for pregnancy and sexually transmitted infections as indicated, and obtains informed consent. On the day of service the patient undergoes office-based placement of a levonorgestrel-releasing intrauterine contraceptive system (J7302, 52 mg). The workflow typically includes pre-procedure counseling and consent, a pregnancy test if appropriate, pelvic exam and cervical cleansing, possible local anesthetic or paracervical block, insertion of the device using sterile technique, confirmation of proper placement, and post-insertion counseling about side effects and follow-up. Typical sites of service are outpatient clinic, ambulatory surgical center, or physician office. Common follow-up includes a visit at 4–12 weeks to assess threads and address adverse effects and a visit whenever the patient is symptomatic.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure	Use when a distinct E/M visit is provided on the same day as IUD insertion and documented separately.

Taxonomy Code	Specialty	Notes
`163W00000X`	Obstetrics & Gynecology	OBGYNs commonly perform IUD insertions and manage contraception.
`207V00000X`	Family Medicine	Family physicians frequently provide contraceptive counseling and in-office IUD placement.
`2586S0205X`	Reproductive Endocrinology	Specialists manage complex contraceptive needs and device placements in complicated patients.
`163WW0100X`	Pediatric & Adolescent Gynecology	Providers who care for adolescents and young adults commonly place IUDs in this population.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z30.430`	Encounter for initial prescription of intrauterine contraceptive	Primary diagnosis when initiating a levonorgestrel IUD.
`Z30.431`	Encounter for removal and replacement of intrauterine contraceptive	Used when replacing an existing IUD with a `J7302` device.
`Z30.49`	Encounter for other long-acting reversible contraception	Used for other LARC encounters when documentation does not fit a more specific code.
`Z30.09`	Encounter for other general counseling and advice on contraception	When counseling is the primary reason for the visit in contraception planning.
`N92.6`	Irregular menstruation, unspecified	Common symptom leading patients to seek levonorgestrel IUD for menstrual management and contraception.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`58300`	Insertion of intrauterine device (IUD), without removal of existing IUD	Commonly performed CPT code for placement of an IUD in an office setting; typically reported when a levonorgestrel IUD is placed.
`58301`	Removal of intrauterine device (IUD) only	Reported when an existing IUD is removed prior to placement of a new `J7302` device; may be performed in the same encounter.
`58306`	Removal and reinsertion of intrauterine device (IUD)	Used when an IUD is removed and a new one is inserted during the same visit; documents combined workflow.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common E/M code reported when a moderate-complexity evaluation and counseling about contraception is provided on the day of insertion.
`99070`	Supplies and materials (except spectacles), provided by physician over and above those usually included with the office visit or procedure	Used for nonstandard supplies or additional materials associated with insertion when payor allows separate billing.

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Summary & Overview

HCPCS Level II J7302: Levonorgestrel-Releasing Intrauterine Contraceptive System, 52 mg