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Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies

HCPCS code

Name of the Procedure:

Contraceptive Intrauterine Device Insertion (IUD)

  • Common Names: IUD, Intrauterine Device
  • Technical Terms: Progestacert IUD

Summary

An intrauterine device (IUD) is a small, T-shaped contraceptive device that is inserted into the uterus to prevent pregnancy. The IUD releases hormones (such as progestin) or uses copper to create an environment that is hostile to sperm and fertilized eggs, thus preventing conception.

Purpose

The primary purpose of an IUD is to provide long-term, reversible contraception. It helps in:

  • Preventing unwanted pregnancies.
  • Managing heavy menstrual bleeding and menstrual pain in some cases of hormonal IUD.

Indications

  • Women seeking long-term contraception.
  • Those who prefer a non-daily method of birth control.
  • Individuals who might have contraindications to estrogen.
  • Patients with heavy menstrual bleeding (for hormonal IUDs).

Preparation

  • No special preparations, such as fasting, are typically needed.
  • An initial pelvic exam and possibly an STI screening prior to insertion.
  • Discussing and reviewing medical history and any medications.

Procedure Description

  1. The patient lies on an examination table similar to a regular gynecological exam.
  2. A speculum is inserted to open the vagina.
  3. A healthcare provider cleans the cervix with an antiseptic solution.
  4. Using a specialized inserter tool, the IUD is placed through the cervical canal into the uterus.
  5. The strings of the IUD are trimmed so they extend slightly into the vagina.

Tools/equipment used include a speculum, antiseptic swabs, inserter tool, and the IUD device itself.

Anesthesia or sedation is typically not required, but a local anesthetic may be used for patient comfort.

Duration

The insertion procedure typically takes about 5 to 15 minutes.

Setting

Performed in a healthcare provider’s office, outpatient clinic, or a family planning clinic.

Personnel

  • Gynecologist or trained healthcare provider
  • Nurse or medical assistant (optional)

Risks and Complications

  • Cramping or pain during and after insertion.
  • Spotting or irregular bleeding.
  • Rare risks include perforation of the uterus, expulsion of the device, pelvic inflammatory disease (PID), and infection.

Benefits

  • Long-term contraception (3-10 years depending on the type).
  • High effectiveness in preventing pregnancy.
  • Immediate return to fertility upon removal.

Recovery

  • Mild cramping and spotting may occur for a few days after insertion.
  • Over-the-counter pain relief and heating pads can help alleviate discomfort.
  • Regular follow-up visits to ensure the IUD remains in place.
  • Avoid insertion during known pregnancy.

Alternatives

  • Oral contraceptive pills: taken daily for pregnancy prevention.
  • Contraceptive implants: a small rod inserted under the skin.
  • Barrier methods: such as condoms or diaphragms.
  • Sterilization: permanent solution for those who don't want future pregnancies.

Pros and Cons of Alternatives:

  • Pills require daily adherence while IUDs are low-maintenance.
  • Implants and sterilizations involve minor surgeries but offer long-term solutions.
  • Barrier methods are non-hormonal but less effective than IUDs.

Patient Experience

During insertion, patients might feel cramping or discomfort similar to menstrual cramps. Post-procedure effects include spotting or mild cramping for a few days. Pain management can be handled with over-the-counter medications and rest as needed. Patients can resume normal activities almost immediately but should follow their healthcare provider’s specific advice.

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