Wiki iud insert and rem same day

Trying to clarify billing this: pt comes in for iud insertion, u/s performed to confirm placement (not billing for u/s), noted to be too low so it is removed, all at same encounter. Should 58300 and 58301 be billed? What modifiers are recommended? TIA

From an insurance standpoint, we would question billing for the removal being billed to insurance because the IUD was placed too low. That is something that we would see more of an issue with the performance of the provider who placed the IUD and why would we pay for the provider not performing the procedure properly that necessitated the removal of the IUD.

I'd also think about it from a patient relations standpoint, how would you as the patient feel if you were charged with the removal of the IUD that required removal because it wasn't placed properly by the provider. Would you want to pay for that as a patient or want it billed to your insurance company even?

CBLENNIE said:

From an insurance standpoint, we would question billing for the removal being billed to insurance because the IUD was placed too low. That is something that we would see more of an issue with the performance of the provider who placed the IUD and why would we pay for the provider not performing the procedure properly that necessitated the removal of the IUD.

I'd also think about it from a patient relations standpoint, how would you as the patient feel if you were charged with the removal of the IUD that required removal because it wasn't placed properly by the provider. Would you want to pay for that as a patient or want it billed to your insurance company even?

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That's my feeling also, I wanted to get some feedback from others due to differing opinions here. Thanks!

I agree with Corinne. The removal was required for the provider to correct their initial mis-placement.
In fact, while looking for a reference on a totally unrelated question, I came across this AAGL article which states:
Difficult Insertions/Failed Insertions CPT Codes:
Modifier 22 can be used if the work is significantly harder than usual or if the device was placed inappropriately, verified wrong by ultrasound, and then removed and a successful insertion occurs. You would not use 58300 and 58301 in this situation. The specific time and effort involved should be documented in the note.

I would only consider 58300-22 if there was documentation of a difficult placement, not just that the provider didn't insert far enough.