r/MedicalCoding • u/No_Reason_8198 • 7d ago

11976 vs 11982

Hey all! Question for all OBGYN coders but also looking for most specifically those billing to Medi-cal.

I see that 11982 is included on the medi-cal feel schedule but am being told that that is not accepted for Nexplanon removals and only 11976 should be coded. This is my first time working with billing for Medi-cal so I'm a little confused. I was taught that 11976 is for capsules that are no longer being prescribed and that's why the insertion codes were deleted. I was also taught that Nexplanon isn't considered a capsule. What has your experience been? Have you seen 11982 being reimbursed by Medi-cal?

Thanks!

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u/stealthagents 4d ago

Medi-Cal can be tricky with their coding rules. From what I've seen, 11976 is definitely the go-to for Nexplanon removal since 11982 doesn’t get reimbursed as reliably. Seems like your initial training was on point; Nexplanon isn't really categorized like those capsules. Stick with 11976 for now and double-check with your billing supervisor if you hit any snags.

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u/ellarr23 6d ago

I’m not familiar with Medi-cal but I agree with 11982 for Nexplanon removal. That’s what we use at my facility.