Summary & Overview
HCPCS Level II J7304: Hormone-Containing Contraceptive Patch, Each
HCPCS Level II code J7304 denotes a single unit of a hormone-containing contraceptive patch supplied for systemic birth control. This product-level code matters nationally because it standardizes billing for a commonly used, non-invasive contraceptive option dispensed in outpatient clinics and pharmacies. Accurate use of J7304 supports consistent claims processing for contraceptive coverage and helps payers and providers track utilization of patch-based hormonal contraception.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for transdermal contraceptive patches, typical sites of service, common billing considerations, and where to look for policy or coverage guidance. The publication highlights benchmarks and policy updates relevant to national contraceptive coverage, outlines typical service lines for dispensing and outpatient provision, and provides practical reference information for claims coding and documentation.
Data not available in the input for detailed payer-specific reimbursement rates, ICD-10 diagnosis mappings, and associated taxonomies.
Billing Code Overview
HCPCS Level II code J7304 describes a contraceptive supply, hormone containing patch, each. This code represents a packaged supply product used for systemic hormone-based contraception delivered via transdermal patch.
Service type: Contraceptive supply / pharmacy-dispensed hormonal patch
Typical site of service: Outpatient clinic or pharmacy dispensing
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 24-year-old female presents to an outpatient family planning clinic requesting initiation of a combined hormonal contraceptive patch for pregnancy prevention. After a brief intake that includes medical history, blood pressure measurement, and screening for contraindications (history of thromboembolism, migraine with aura, smoking status over age 35), the clinician confirms eligibility. The clinician provides counseling on proper patch application, expected side effects, and a follow-up plan. A dispensing nurse or pharmacist supplies one or more units of the hormone-containing transdermal patch billed as J7304 per patch supplied. Typical workflow steps: patient check-in and eligibility screening, clinician visit and counseling, patient education on application and adverse effects, documentation of lot number and expiration in the medical record, and dispensing of the patch with billing to the patient’s insurer.
Typical site of service is an ambulatory clinic, family planning or primary care office, outpatient pharmacy, or community health center. The typical patient is a reproductive-age individual seeking contraception or contraceptive replacement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Use when no specific modifier applies and billing as standard supply |