LARCs during the postpartum period

LARCs during the postpartum period

In order to maximize the time before termination of Medicaid coverage for pregnant women, we recommend scheduling the postpartum visit at 3 to 5 weeks after delivery. This allows sufficient time to bring the patient back for Long-acting Reversible Contraception (LARC) insertion before termination of benefits and after the postpartum visit has been completed.

For LARCs, the provider will bill for both insertion of the device and the device itself. The date of the insertion and the date of the device claim do not have to be the same to get reimbursement.

For details regarding the “buy and bill” method versus the “pharmacy” method, please see the Texas LARC Toolkit (p. 21-25): http://tinyurl.com/yb8fqobx .

For reference:

LARC Insertion Codes

Code Description
58300 IUD Insertion
11981 Implant Insertion

 

LARC Codes

Code Description
J7297 Liletta®
J7298 Mirena®
J7300 Paragard®
J7301 Skyla®
J7307 Nexplanon®

 

Don’t forget: the postpartum visit can only be billed once and only during the 21 to 56 days after delivery (using CPT code 59430). This measure will not be met if the visit takes place outside of this timeframe.

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