Limited follow-up follicular transvaginal ultrasound

Posted January 30, 2015

What is the appropriate code to use for a limited follow-up follicular transvaginal ultrasound? There is no established code for this. Should a 52 modifier be used if all the complete ultrasound measurements are not taken? What about a limited follow up transvaginal ultrasound? 

Billing for embryo culture after freezing

Posted December 12, 2014

 Is it allowable to bill 89250 for the culture of embryos after thaw for a frozen embryo transfer (FET) cycle? Is there a certain time that the embryos must be in culture? The CPT code says <4 days.

Correct coding for evaluation to determine infertility

Posted October 7, 2014

If a patient and partner present to our office with a six-month or one-year history of failure to conceive with no previous testing or treatment, we have been using the V26.21 diagnosis code, as it seems to be most appropriate for the male and female diagnostic testing phase, such as semen analysis, sonohysterogram and egg quality testing.

It seems that giving a female infertility code such as 628.x or 606.x for male infertility would be inappropriate because we don’t know yet who is infertile. We have only recently started having problems with this code and only with one major commercial insurer who is stating that we should be using the infertility codes. so it has now raised the question: are we in the right?


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