Summary & Overview
HCPCS Q9984: Levonorgestrel IUD (Kyleena) 19.5 mg
HCPCS Level II code Q9984 denotes the levonorgestrel-releasing intrauterine contraceptive system (Kyleena), 19.5 mg. This device is used for long-acting reversible contraception and is significant for national family planning access and cost management because intrauterine systems shift contraception delivery to single-encounter device placement with ongoing contraceptive effect. Payers and providers track this code for coverage, pharmacy or medical benefit routing, and site-of-service considerations.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn clinical and billing context for device use, typical settings for insertion and follow-up, and which payers are commonly involved in coverage determinations. The publication outlines benchmarks and payment considerations, summarizes policy updates affecting contraceptive device coverage, and provides clinical context for billing in outpatient and ambulatory settings.
The report emphasizes national implications for access to long-acting reversible contraception, coding clarity between device supply and insertion services, and payer routing (medical benefit versus pharmacy benefit). Data not available in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code Q9984 represents a levonorgestrel-releasing intrauterine contraceptive system (Kyleena), 19.5 mg. This device is a long-acting reversible contraceptive intended for intrauterine placement to provide continuous local progestin delivery for pregnancy prevention.
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Service type: Intrauterine device placement (contraceptive implantable device delivery)
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Typical site of service: Outpatient clinic, ambulatory surgery center, or physician office for insertion and follow-up visits
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 29-year-old woman presents to an outpatient gynecology clinic seeking long-acting reversible contraception. She desires a low-dose levonorgestrel intrauterine system for pregnancy prevention for up to several years. After counseling, informed consent, pregnancy test, and screening for pelvic infection and uterine anomalies, the clinician performs insertion of the levonorgestrel-releasing intrauterine contraceptive system Q9984 (Kyleena, 19.5 mg) during the office visit. The workflow includes a pre-procedure history and physical, documentation of counseling and consent, pregnancy testing, a pelvic exam to assess uterine size and position, the insertion procedure with sterile technique, post-procedure instructions, and scheduling of a follow-up visit (typically 4–6 weeks) to confirm placement and address any adverse effects such as abnormal bleeding or cramping.
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 documented on the same day as insertion separate from the intrauterine device procedure |
59 | Distinct procedural service | Use if another distinct procedure unrelated to the IUD insertion is performed the same day |
76 | Repeat procedure or service by same physician | Use when the insertion attempt is repeated by the same provider on the same day |
77 | Repeat procedure or service by another physician | Use when a different physician repeats the insertion same day |
22 | Increased procedural service | Use when work required is substantially greater than typical and well-documented |
52 | Reduced services | Use when insertion is partially reduced or not completed for clinical reasons |
53 | Discontinued procedure | Use when procedure is started but stopped due to patient intolerance or complication |
24 | Unrelated E/M service during a global period | Use for an E/M visit unrelated to the device care during the global period |
JA | Product selection modifier (J-codes) — product selection | Use when reporting origin of device product selection for pricing or coverage when applicable |
RT | Right side | Rarely applicable; use when laterality reporting is required for a procedure with laterality |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207V00000X | Obstetrics & Gynecology | Primary specialty performing IUD insertions and contraceptive counseling |
208000000X | Family Medicine | Frequently provides contraceptive services including IUD insertion in office settings |
163W00000X | Women’s Health Nurse Practitioner | Advanced practice providers who commonly perform insertions under scope of practice |
363A00000X | Certified Nurse Midwife | Midwives who provide contraceptive device services including intrauterine systems |
1835S0001X | Reproductive Endocrinology (and Infertility) | Specialists who may insert IUDs in complex gynecologic cases |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
Z30.430 | Encounter for insertion of intrauterine contraceptive device | Primary diagnosis used to indicate insertion of an intrauterine contraceptive system |
Z30.432 | Encounter for removal and reinsertion of intrauterine contraceptive device | Used when an existing IUD is removed and a new levonorgestrel system is inserted in same encounter |
Z30.431 | Encounter for removal of intrauterine contraceptive device | Relevant when removal is performed instead of insertion |
N72 | Inflammatory disease of cervix uteri | May contraindicate immediate insertion; relevant to screening and postponement decisions |
N76.0 | Acute vaginitis | Infection that may delay insertion until treated |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
11981 | Separate procedure code for insertion of long-acting contraceptive drug delivery system (e.g., intrauterine) | Main procedure code commonly billed for insertion of a levonorgestrel-releasing intrauterine system in conjunction with device supply code Q9984 |
58300 | Insertion of intrauterine device (IUD) | Alternate surgical insertion CPT code used for placement of an IUD in some practices |
99213 | Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes | Common E/M code for pre-procedure counseling, evaluation, and same-day decision-making when a significant E/M is documented |
81025 | Urine pregnancy test, by dipstick or tablet reagent for pregnancy (over-the-counter) | Used prior to insertion to confirm non-pregnancy |
87635 | Infectious agent detection by nucleic acid (e.g., chlamydia, gonorrhea) | Commonly performed screening tests before IUD insertion when indicated |