HealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsMarch 31, 2023
Family planning and long-acting reversible contraception
Please note, this communication applies to Anthem HealthKeepers Plus Medicaid products offered by HealthKeepers, Inc.
The American College of Obstetricians and Gynecologists (ACOG) recommends having a conversation with your patient in their third trimester regarding immediate postpartum placement of long-acting reversible contraception (LARC) as an effective option for postpartum contraception. There are few contraindications to postpartum intrauterine devices and implants.1
The reimbursement from HealthKeepers, Inc. is the same for immediate postpartum placement and outpatient placement of LARC. Please follow the American Academy of Pediatrics guidance and provide additional counseling and support to your teenage and young patients (ages 13 to 19), as this group is at the greatest risk for early discontinuation of these methods.2 Additional information about postpartum placement of LARC can be found at acog.org.
How this benefit works
During an inpatient facility admission, you can implant the covered device of your patient’s choice and receive the same reimbursement from HealthKeepers, Inc. as if the device was implanted in an outpatient setting. The inpatient facility will provide the device. Please work closely with your OB unit to understand the logistics of obtaining devices.
LARC FAQ
Q: When should providers insert an intrauterine device (IUD) or Nexplanon® postpartum?
A: Providers can insert IUDs in the postpartum period:
- Within 10 minutes after delivery of the placenta.
- Up to 48 hours after delivery.
- At the time of cesarean delivery.
Q: When should patients avoid postpartum IUD placement?
A: Immediate post-placenta insertion should be avoided in patients with a fever. Additionally, patients with rupture of membranes greater than 36 hours before delivery, a postpartum hemorrhage, or extensive genital lacerations should be referred for interval insertion.
Q: What are the CPT® codes associated with IUD and Nexplanon insertion in the hospital setting?
A: The CPT and associated ICD-10-CM codes are unchanged for the hospital setting:
- 11981 — insertion, nonbiodegradable drug delivery implant
- 58300 — insertion of an IUD
Q: Does placement of an IUD in the postpartum period increase a woman’s chance of infertility in the future?
A: No, there is no data to suggest that there is any adverse effect on future fertility. Baseline fecundity has been shown to return rapidly after IUD removal.
Q: Is there a greater rate of IUD expulsion with postpartum placement of an IUD?
A: “Expulsion rates for immediate postpartum IUD insertions are higher than for interval or postabortion insertions, vary by study, and may be as high as 10 to 27%. Research is underway to determine whether levonorgestrel IUDs have different expulsion rates than copper devices in the immediate postpartum setting. Women should be counseled about the increased expulsion risk, as well as signs and symptoms of expulsion. Replacement cost may vary by insurance plan, and a woman who experiences or suspects expulsion should contact her obstetrician-gynecologist or other obstetric care provider and use a back-up contraceptive method.”3
Q: When should patients be seen in follow-up?
A: Patients should be seen between 7 to 84 days after delivery. For a complicated pregnancy or birth, the patient should be seen sooner rather than later. Many patients resume intercourse before their postpartum checkup. To prevent unintended pregnancies, it is important to confirm that the device is still in place.
If you have any questions about this communication, call Anthem HealthKeepers Plus Provider Services at 800-901-0020.
VABCBS-CD-017637-23
PUBLICATIONS: April 2023 Provider News - Virginia
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