Paragard Access Center®

Paragard® Billing & Reimbursement

Billings Codes

Documenting Paragard IUS placement and subsequent care with appropriate coding is a key part of the billing process. The CPT/J-codes below may be used when filing claims. Be sure to check with your patient’s individual insurance carrier, as payers vary in their claim reporting requirements.

CPT Code1
58300 Intrauterine contraceptive device insert
J-Code1
J7300 Intrauterine copper contraceptive

CPT procedure Codes do not include the cost of Paragard. Use the Healthcare Common Procedure Coding System (HCPCS)/J-Code, J7300, to report use of a unit.1

To complete the claim, you may also need to report:

Drug name: Paragard T380A (intrauterine copper contraceptive)
Quantity: 1
National Drug Code (NDC):

LABELER NDC
Teva Women’s Health 51285-204-01
CooperSurgical 59365-5128-1 (10-digit)
CooperSurgical 59365-5128-01 (11-digit)

Route of administration: Intrauterine
How supplied: Carton of 1 sterile unit

Reimbursement Appeals

How to Appeal an Under-Reimbursed Claim

Before beginning a formal appeal process, you should first do the following:

  • Call the health plan to confirm the procedure required for the appeal, verify eligibility and reimbursement amounts
    • Be prepared to provide the health plan with the claim number and all the information on the original claim that was not paid correctly
    • Amounts may vary due to special contracts between an employer group and the health plan, so be prepared to provide the health plan with the employer name and/or group number
  • If not satisfied after calling the health plan, you may want to file a letter of appeal with the health plan and include the original claim

How to Create an Appeal Letter for Paragard (HCPCS J7300)

Create your own letter to address the under-reimbursement or utilize the Sample Letter of Appeal for Payment HCPCS J7300.

  • If using the Paragard sample letter of appeal template – please copy and paste content onto practice letterhead, fill in the blanks accordingly, and add any additional information to support your appeal

Please include the following documents with your appeal letter to assist with the health plans consideration and determination for adjusting payment:

NOTE: Some health plans will require or request a copy of the invoice purchase price.

Disclaimer: The patient’s health plan should always be the first line of contact when disputing a claim. Filing an appeal for under-reimbursement may or may not result in an adjustment of payment. There are no guarantees of payment at any particular rate, and coverage and payment rates may vary depending on a number of factors (e.g., payor coverage policies, provider contracts).

Important Safety Information

  • Paragard must not be used by women who had a post-pregnancy or post-abortion uterine infection in the past 3 months; have cancer of the uterus or cervix; acute pelvic inflammatory disease (PID); an infection of the cervix; an allergy to any component (including copper); or Wilson’s disease. Continue reading

Indication

Paragard is a copper-containing IUS (intrauterine system) indicated for the prevention of pregnancy for up to 10 years.

Important Safety Information

  • Paragard must not be used by women who had a post-pregnancy or post-abortion uterine infection in the past 3 months; have cancer of the uterus or cervix; acute pelvic inflammatory disease (PID); an infection of the cervix; an allergy to any component (including copper); or Wilson's disease.
  • If a woman misses her period, she must be promptly evaluated for ectopic pregnancy.
  • Possible serious complications that have been associated with IUSs are PID, embedment, perforation of the uterus, and expulsion.
  • Paragard must not be used by pregnant women as this can be life threatening and may result in loss of pregnancy or infertility.
  • Menstrual cycles may become heavier and longer with intermenstrual spotting. Bleeding may be heavier than usual at first.
  • Paragard does not protect against HIV or STIs.

Please see accompanying Full Prescribing Information.

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