July 20, 2017
Effective July 1, 2017, the Centers for Medicare and Medicaid Services (CMS) created a new, temporary code to represent the Kyleena™ contraceptive device. The new code is “Q9984-Levonorgestrel-releasing intrauterine contraceptive system (Kyleena), 19.5 mg” and was part of a Healthcare Common Procedure Coding System (HCPCS) code update. Kyleena was approved by the Food and Drug Administration (FDA) on September 16, 2016.
When billing for Kyleena with dates of service July 1, 2017, and after, submit this new code rather than coding “J3490-Unclassified drug.” Failure to use this new code for Kyleena as of July 1, 2017 dates of service and after will result in a denial and a request to resubmit with the correct code.
Standard coding guidelines indicate that when there is a CPT or HCPCS code that more accurately describes the service being rendered, the specific CPT or HCPCS code should be used, rather than an unlisted code. Specific CPT or HCPCS codes always take precedence over an unlisted or miscellaneous code. Review the Payment Policy Unlisted, Non-Specific and Miscellaneous Procedure Codes for instructions on when to use and when not to use “unlisted” codes.
See quarterly HCPCS code updates on the CMS website.
The code update can be found in the first link under “Other Codes (other than C and G HCPCS codes).”