Billing and Coding: IUD (Hormone-Eluting) for Endometrial Hyperplasia - CPT 58999

Noridian allows progestin-containing (hormone) IUD insertion billed as CPT 58999 for Medicare beneficiaries with endometrial hyperplasia—particularly simple hyperplasia without atypia (ICD-10 N85.01)—and may accept unspecified endometrial hyperplasia (N85.00). CPT 58300 and IUD placement billed for contraception are not covered; claims must include medical necessity documentation and the product description 'hormone IUD for endometrial hyperplasia' in Item 19 of the CMS-1500 (or electronic equivalent).

"Progestin-containing (hormone) IUD insertion may be approved for Medicare beneficiaries diagnosed with simple endometrial hyperplasia without atypia (ICD-10 N85."

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