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

Medicare may approve insertion of a progestin-containing (hormone) IUD billed with CPT 58999 for beneficiaries diagnosed with endometrial hyperplasia without atypia, particularly when surgery is not appropriate or the patient wishes to preserve fertility. CPT 58300 (IUD insertion) is not payable to Medicare (N status) and will be denied; providers must document medical necessity clearly, use accurate diagnosis coding, and include the product description 'hormone IUD for endometrial hyperplasia' on claims.

"Medicare beneficiary with endometrial hyperplasia without atypia is eligible for coverage of a progestin-containing hormone IUD for management of the condition."

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