Billing and Coding: Endometrial Hyperplasia Treatment

Palmetto GBA reimburses insertion of a hormone-containing IUD for treatment of endometrial hyperplasia in patients with abnormal uterine bleeding who cannot tolerate oral megestrol or are at high risk for megestrol complications. Coverage applies for dates of service on or after 02/01/2012 and claims will auto-deny unless CPT 58999, the appropriate ICD-10 code (N84.0 or N85.00–N85.02), and the phrase "hormone IUD" are submitted in the claim narrative.

"Insertion of a hormone-containing intrauterine device (IUD) to treat endometrial hyperplasia in patients with abnormal uterine bleeding who are unable to tolerate oral megestrol or are at high risk..."

Sign up to see full coverage criteria, indications, and limitations.