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Newsletter Vol. 12, No. 90
Act
by Sep 1, 2002
Effective date
Sep 1, 2002
Identified
Jun 20, 2026
Summary
New Jersey Medicaid/NJ FamilyCare is discontinuing all-inclusive Level III IUD billing codes (W-series) effective September 1, 2002, and replacing them with separate HCPCS codes for insertion/removal procedures (58300, 58301) and J-codes for the device itself (J7300 for Paragard, J7302 for Mirena). Billing teams must update systems to use the new code structure and ensure proper modifiers and family planning indicators are applied on CMS 1500 claim forms.
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What to do
by Sep 1, 2002 · 6 steps
01Billing team must immediately discontinue use of the following legacy codes: W0001, W0001 WM, W0001 AV, W0002, W0002 WM, W0002 AV, W0004, W0004 WM, W0004 AV, W0008, W0008 WM, and W0008 AV.
02Update billing software to use new HCPCS codes 58300 (insertion) and 58301 (removal) with appropriate modifiers (blank for physician, WM for nurse-midwife, AV for nurse practitioner/clinical nurse specialist).
03For device reimbursement, apply J7300 (Paragard) or J7302 (Mirena) as appropriate.
04Ensure all IUD insertion/removal claims include: (1) proper procedure code with modifier; (2) corresponding J-code for device; (3) family planning indicator '2' (age 21+) or '3' (under 21) in block 24H of CMS 1500 form; (4) AWP or acquisition cost in block 24F for J-codes.
05Train billing and clinical staff on new workflow.
06Claims submitted with legacy W-codes after September 1, 2002 will be denied.
Codes mentioned
5830058301J7300J7302
Original notice
Newsletter Vol. 12, No. 90
njmmis.com · Always check the source before changing claims.