Billing and Coding: Endometrial Hyperplasia Treatment with Intrauterine Device (Hormone-Eluting)

Medicare may cover a progestin-containing intrauterine device (delivering hormones for up to 5 years) as reasonable and necessary treatment for endometrial hyperplasia without atypia in patients with abnormal uterine bleeding, those intolerant to oral megestrol, those who are not surgical candidates, or who wish to preserve fertility. For atypical complex hyperplasia/EIN, IUD therapy is limited to patients documented to be poor surgical candidates; contraceptive devices billed under CPT 58300 are not payable by Medicare and insertion should be billed under CPT 58999 with appropriate documentation including TVUS showing endometrial stripe >4 mm and pathology reports.

"Progestin-containing intrauterine device (IUD) delivering progestins over 5 years is a reasonable treatment for endometrial hyperplasia without atypia in patients presenting with abnormal uterine b..."