Question 1

What is HCPCS code J7298?

Accepted Answer

HCPCS code J7298 is "Mirena, 52 mg". Levonorgestrel-releasing intrauterine contraceptive system (mirena), 52 mg

Question 2

What category is J7298 in?

Accepted Answer

J7298 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J7298?

Accepted Answer

Use J7298 when billing for mirena, 52 mg. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is J7298 covered by Medicare?

Accepted Answer

Coverage for J7298 (Mirena, 52 mg) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for J7298?

Accepted Answer

Documentation for J7298 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).