Review IUD Medical Information
Please make sure that the IUD type you are interested in is the best option for you. IUDs vary by size and hormone content. Your Arbor ObGyn physician or nurse practitioner should have provided you with a manufacturer’s brochure about the IUD. If you did not receive it, or need additional information, please refer to the manufacturer’s website:
- Mirena (levonorgestrel) www.mirena-us.com
- Kyleena (levonorgestrel) www.kyleena-us.com
- Skyla (levonorgestrel) www.skyla-us.com
- Paragard (copper) www.paragard.com
Reviewing the Request for IUD and Insurance Considerations
Once your Arbor ObGyn provider requests an IUD insertion appointment for you, our Surgery & Referral coordinators will review your insurance and work with you to schedule this procedure. Arbor purchases the IUD and your insurance reimburses us at a contracted rate. The cost of the actual IUD and the cost of the insertion/removal procedure are separate charges. Once the request is reviewed and we have the IUD of your choice in stock, a message is sent to you via the Patient Portal. Please log in to the Patient Portal to review. You will be ask to confirm that you would like the IUD to be placed by replying to that message, and give a good time and phone number to contact you so that an appointment can be arranged.
Insurance pre-authorization for IUDs is not required. Previously we contacted your insurance carrier as a courtesy to you, since high out-of-pocket costs to the patient could rarely occur. We are no longer able to perform this service, since telephone wait times on hold have regularly exceeded one hour. Fortunately the current health care laws require contraceptives –including IUDs—to be included as basic services under you Preventive Health benefits with no-cost sharing when provided by an in-network provider for members of non-grandfathered health plans.
Nonetheless, you may consider contacting your Insurance Carrier directly to confirm that your benefits will be valid on the date of the IUD procedure. If your insurance claim is denied for any reason after the device is placed you will still be responsible for fees which will exceed $1,000. For your reference when you call, the ICD-10 diagnosis codes are: Insertion of IUD (z30.430), Checking of IUD (z30.431), Removal of IUD (z30.432), Removal & Reinsertion of IUD (z30.433). The CPT Procedure codes are: IUD Insertion (58300), IUD Removal (58301), Ultrasounds (76857). The actual device cost codes are: Mirena IUD (J7298), Kyleena IUD (J7296), Skyla IUD (J7301), Paragard IUD (J7300).
Arbor ObGyn uses ultrasound guidance at almost every IUD placement to identify the size, shape, and angle of your uterus. This allows a safer placement procedure to reduce the risk of uterine perforation or suboptimal placement. Ultrasound is sometimes used at the follow-up appointment as well to check the IUD. Ultrasound guidance may require a co-insurance payment at either the time of placement or follow-up. Please check with your insurance carrier if you would like to know your obligated costs.
There is usually no separate office visit charge in addition to the charge for the IUD placement. Your 4-8 week follow-up visit is considered an office visit however, and will require your standard co-pay as determined by your insurance carrier.
We can both remove and replace an IUD at a single appointment. We can remove (only) an IUD at an annual wellness appointment. However, be aware that insurance carriers will not pay for insertion of a new IUD at the time of your annual gynecologic wellness appointment.
Schedule an Appointment for Placement of the IUD
Before we call you, please review the preparation information below so that your appointment can be appropriately timed with regards to your menstrual cycle. Once you also have reviewed your insurance benefits Patient Portal message, simply REPLY to the message indicating your desire for the IUD placement. Please list some dates & times that would work for placement. Please reply with a good phone number and time to reach you so that we can call you to schedule the placement.
Preparation for Your IUD Placement Appointment
Carefully review the information below so that your IUD placement appointment is correctly scheduled, and so that Arbor ObGyn will not cancel your procedure when you arrive.
Placement of an IUD at the time of an unknown early pregnancy could cause miscarriage or complications with the pregnancy. It is important that you take precautions to ensure that you are NOT pregnant at the time of your appointment. Please make sure that you use effective contraception with any sexual activity for the two weeks prior to your IUD placement. Your IUD will not be placed if you have sex without contraception within two weeks. “Breastfeeding”, “withdrawal”, and “natural family planning” for example are NOT considered contraceptive methods in preparation for IUD placement because of the high unintended pregnancy rates. If you are not using contraception (condoms, pills, etc.) then simply do not have sex for two weeks before your appointment.
Timing with Menstruation
It is our preference to place the IUD either during or shortly after your menstrual cycle. The cervix is generally slightly more open at this time allowing a more comfortable procedure. In addition, this also helps to ensure that the IUD is not placed during an unexpected pregnancy. If you have predictable and regular menstrual cycles, please call to schedule your IUD during this time window. If you do not have predictable cycles, please wait until your cycle comes and call on the first day so that we can schedule it soon after. If you are post-partum, breast-feeding, or don’t have menstrual cycles we can place it at any time. If you already have an IUD in place, it can be removed/replaced at any time.
Medication Before You Arrive
Taking an anti-inflammatory pain medication such as over-the-counter ibuprofen 600-800 mg (Motrin, Advil) can reduce discomfort during an IUD placement. Please take this medication with food approximately one hour prior to your procedure. For selected patients your provider may have prescribed an additional medication such as misoprostol (Cytotec) orally on the morning of the procedure. Follow the instructions on the prescription bottle.
You should expect to be in the Arbor ObGyn office for approximately 30 minutes. A urine pregnancy test is required when you arrive. The pelvic exam, ultrasound, and IUD placement takes about five minutes. You may drive home by yourself.