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New Jersey MedicaidMedicaid · Billing Codes · Coding · NJ · OB-GYN, Family Medicine, General PracticeHigh impact

Newsletter Vol. 12, No. 88

Act
by Sep 1, 2002
Effective date
Sep 1, 2002
Identified
Jun 20, 2026

Summary

Effective September 1, 2002, New Jersey Medicaid/NJFamilyCare discontinued all-inclusive IUD billing codes (W0001 AV, W0002 AV, W0004 AV, W0008 AV) and now requires separate billing for IUD insertion/removal procedures (CPT 58300, 58301) and devices (J-codes J7300 for Paragard, J7302 for Mirena). CNPs/CNSs must update billing procedures to use the new HCPCS codes and populate the family planning indicator field on CMS 1500 claim forms.

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What to do

by Sep 1, 2002 · 7 steps
01Billing team must immediately discontinue use of deprecated codes W0001 AV, W0002 AV, W0004 AV, and W0008 AV for all IUD claims.
02Update billing software and encounter forms to use CPT 58300 (insertion with post-insertion visit, max $29.85) and CPT 58301 (removal, max $16.40) with modifier AV.
03For IUD devices, bill J7300 (Paragard) or J7302 (Mirena) separately at AWP or acquisition cost, whichever is lower.
04On all CMS 1500 claim forms, complete block 24H (family planning indicator) with "2" for beneficiaries 21+ years or "3" for under 21.
05Ensure modifier AV is appended to procedure codes.
06Train all CNPs/CNSs and billing staff on new procedures.
07Claims submitted with old codes after September 1, 2002 will be denied or require resubmission.

Codes mentioned

5830058301J7300J7302

Original notice

Newsletter Vol. 12, No. 88
njmmis.com · Always check the source before changing claims.
View original ↗

Related changes

See all New Jersey Medicaid changes →
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Related policy hubs

New Jersey Medicaid policiesNJ policy changesOB-GYNFamily MedicineGeneral PracticeCode 58300Code 58301Code J7300Code J7302

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