Question 1

What is HCPCS code J7295?

Accepted Answer

HCPCS code J7295 is "Eth estr and eton monthly". Ethinyl estradiol and etonogestrel 0.015mg, 0.12mg per 24 hours; monthly vaginal ring, each

Question 2

What category is J7295 in?

Accepted Answer

J7295 belongs to HCPCS Category J (Drugs Administered Other Than Oral).

Question 3

When should I use HCPCS code J7295?

Accepted Answer

Use J7295 when billing for eth estr and eton monthly. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is J7295 covered by Medicare?

Accepted Answer

Coverage for J7295 (Eth estr and eton monthly) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for J7295?

Accepted Answer

Documentation for J7295 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).