Billing for E/M Visits
Login now to view this Coding information. Coding Resources are available to ASRM Members only.
If you are not an ASRM member and would like to be, visit the Membership Tab above.
Coding Q&A
View more Coding Q&A in this categoryBilling for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would weWhen to use code Z31.83
When a patient is completing an approved fertility cycle, is it necessaryBilling Physician vs Service Physician
What physician’s name must be on the treatment notes and who we are permitted to bill to insurance for:More Resources
ASRM MAC Tool 2021
The ASRM Müllerian Anomaly Classification 2021 (MAC2021) includes cervical and vaginal anomalies and standardize terminology within an interactive tool format.
EMR Shared Phrases/Template Library
This resource includes phrases shared by ASRM physician members to provide a template for individuals to create their own EMR phrases.
ASRM Practice Documents
ASRM Ethics Opinions
Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.
Coding Corner Q & A
The Coding Corner Q & A is a list of previously submitted and answered questions from ASRM members about coding. Answers are available to ASRM Members only.
COVID-19 Resources
A compendium of ASRM resources concerning the Novel Corona virus (SARS-COV-2) and COVID-19.
Patient Resources
ReproductiveFacts.org provides a wide range of information related to reproductive health and infertility through patient education fact sheets, infographics, videos, and other resources.
Topic Resources
Fertility and Sterility On Air - Unplugged: October 2024
Topics include: mechanical contractions and fibroid progression, endometriosis classification and risk of infertility, fertility coverage for military personnel and more. Listen to the EpisodeHow to Spot Endometriosis in 10 Minutes!
Learn how to identify endometriosis in patients within 10 minutes by gathering thorough menstrual history, spotting GI symptoms, and building a support team. View the ASRMed Talk VideoWhat's New from the Fertility and Sterility Family of Journals
Fertility and Sterility On Air - TOC: May 2024
Topics this month include Iatrogenic and demographic determinants of the national plural birth increase, outcomes between ICSI and IVF with PGT-A. Listen to the EpisodeWhat's New from the Fertility and Sterility Family of Journals
Journal Club Global: Actualidad En Tratamientos De Fertilidad Para Pacientes Con Endometriosis
Live in Spanish from the 2024 Peruvian Fertility Society Meeting - Lima, Peru View the VideoExclusion of IVF services due to Z31.83
My wife and I have been seeking IVF treatment and this year coverage was added to my benefits for infertility treatment (up to $25,000). View the AnswerCoding for aspiration of hydrosalpinx and endometrioma
Surgery was performed under anesthesia for Aspiration of right hydrosalpinx fluid and right endometrioma. Which CPT code would be best to use? View the AnswerIVF coverage denied for Z31.83 diagnosis code
My wife and I have been seeking IVF treatment and coverage was added for infertility treatment (up to $25,000) but our insurer keeps denying it. View the AnswerEndometriosis and infertility: a committee opinion (2012)
Women with endometriosis typically present with pelvic pain, infertility, or an adnexal mass, and may require surgery. View the Committee OpinionMedication Administration
Is CPT code 96402 applicable to a Depo-Lupron or Zoladex injection by nurse at REI practice, even if there is no diagnosis of cancer? View the AnswerEndometriosis and Infertility
For treatment like IVF would we bill with N97.x first or an endometriosis diagnosis? View the AnswerExcision Ovarian Endometrioma
What code is used for a laparoscopic excision of endometriosis and an ovarian excision of endometrioma with bilateral ureterolysis is performed. View the AnswerEndometriosis
A summary of common codes for Endometriosis compiled by the ASRM Coding Committee View the Coding SummaryDrs. Camran, Farr, and Ceana Nezhat Travel Scholar Award for Endometriosis
The objective of this award is to provide any trainee whose abstract submission focuses on endometriosis to expand their experience in the field. View the Award InformationJournal Club Global: Surgical management of endometriosis in women diagnosed with infertility (Spanish language)
Journal Club Global: Non-invasive Diagnosis of Endometriosis
One of the most exciting developments in the field of endometriosis is the push towards earlier and less invasive approaches to diagnosis. View the VideoJournal Club Global - Does the Endometrium Play a Major Role in Endometriosis-Associated Infertility
This will be a virtual event in the style of the "Fertile Battle" debate that took place at the 2019 SREI Fellows Symposium View the VideoFeb 2023: New Endometriosis and Isthmocele Codes
On June 9, 2022 the CDC issued updates to the ICD-10-CM code set reflecting more than 1,400 changes to your diagnosis coding options. View the LetterBest practices of ASRM and ESHRE: a journey through reproductive medicine (2012)
ASRM and ESHRE are the two largest societies in the world whose members comprise the major experts and professionals working in reproductive medicine. View the Committee Joint GuidelineEndometriosis Special Interest Group (EndoSIG)
The mission of the Endometriosis Special Interest Group (EndoSIG) is to further the goals of the ASRM by fostering increased interest in the biology, pathophysiology and clinical management of endometriosis. Learn more about the EndoSIGTopic Resources
Use of preimplantation genetic testing for monogenic adult-onset conditions: an Ethics Committee opinion (2024)
Preimplantation genetic testing for adult-onset monogenic diseases is ethically allowed when fully penetrant or conferring disease predisposition. View the Committee OpinionFertility Care Gets Important Win in California
ASRM celebrates California's SB 729, expanding IVF coverage for same-sex couples and singles, advancing equitable fertility care access.
View the Press ReleaseAppropriate Use of Modifier -25
Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the AnswerBilling for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the AnswerWhen to use code Z31.83
When a patient is completing an approved fertility cycle, is it necessary View the AnswerTimed Intercourse Cycle Codes
Is it appropriate to utilize codes N97.8 or View the AnswerThe use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)
PGT-A use in the U.S. is rising, but its value as a routine IVF screening test is unclear, with mixed results from various studies. View the Committee OpinionNational Infertility Awareness Week
April 20-26, 2025, is National Infertility Awareness Week (NIAW)!
View the NIAW ToolkitFertility Support and AI: Help or Hinderance
Discover how fertility apps impact patient care and nursing staff. Explore the balance between tech and human touch in complex fertility treatments View the ASRMed Talk VideoFertility and Sterility On Air - Seminal Article: Ernest Ng and Zhi Chen
June issue Seminal Contribution: a randomized controlled trial studying the use of progestins for ovulation supression in predicted high responders. Listen to the EpisodeASRM announces support for HOPE with Fertility Services Act
The American Society for Reproductive Medicine is proud to endorse the HOPE with Fertility Services Act (HR 8821).
View the Press ReleaseHyCoSy and CPT 74740
When Office HSG/HyCoSy is performed but no x-ray/fluoroscopic imaging is performed, only ultrasound is done, is it appropriate to bill CPT code 74740? View the AnswerSubclinical hypothyroidism in the infertile female population: a guideline (2024)
This guideline reviews the risks and benefits of treating subclinical hypothyroidism in female patients with a history of infertility and miscarriage. View the Committee GuidelineTobacco or marijuana use and infertility: a committee opinion (2023)
In the United States, approximately 21% of adults report some form of tobacco use, although 18% report marijuana use. View Committee OpinionJournal Club Global: The future of REI Fellowship training: debating opportunities and threats
This exciting collaboration discusses the controversy and future directions for the field of Reproductive Endocrinology and Infertility medicine. View the VideoJournal Club Global: Infertility and Subclinical Hypothyroidism
The impact of treating SCH on fertility, obstetric outcomes, and offspring neurocognitive development is debated in the literature. View the VideoEthical considerations for telemedical delivery of fertility care: an Ethics Committee opinion (2024)
Telemedicine has the potential to increase access to and decrease the cost of care. View the Committee OpinionEthical obligations in fertility treatment when intimate partners withhold information from each other: an Ethics Committee opinion (2024)
Clinicians should encourage disclosure between intimate partners but should maintain confidentiality where there is no harm to the partner and/or offspring. View the Committee OpinionDefinition of infertility: a committee opinion (2023)
‘‘Infertility’’ is a disease, condition, or status characterized by several factors. View the Committee OpinionDiagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion (2023)
It is the responsibility of the clinician to assess for erectile dysfunction, ejaculatory dysfunction, or diminished libido in men presenting for infertility. View the Committee OpinionJournal Club Global - Actualización en la suplementación con progesterona en fase lútea para transferencias de embriones congelados
Efectividad del rescate de progesterona en mujeres que presentan niveles bajos de progesterona circulante alrededor del día de la transferencia de embriones View the VideoThe International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)
Terms and definitions currently used infertility care, infertility and medically assisted reproduction (MAR) can have different meanings that are dependent upon the setting, their usage in research or clinical interventions, or among diverse populations.View the Committee Joint Guideline
Endometriosis and infertility: a committee opinion (2012)
Women with endometriosis typically present with pelvic pain, infertility, or an adnexal mass, and may require surgery. View the Committee OpinionTesting With No History of Infertility
What diagnosis codes should providers submit to insurance carriers while trying to evaluate fertility issues? View the AnswerSelf-referred New Patient
A patient self-refers to our physician for an initial new patient consultation instead of referred by another physician, how do we code for the consult? View the AnswerSurgery Coding
I took the ASRM coding course, and in that course, coding for bilateral neosalpingostomies was coded using only a dx of N70.11 (hydrosalpinx). View the AnswerTelephone Consult
Does a physician need to speak directly to a patient to code for a telephone consult (99371-99373) or can a staff member relay physician notes to patients? View the AnswerPost Vasectomy Infertility
If a husband has had a vasectomy, does the sterilization code apply to the wife's visits? View the AnswerPregnancy Of Uncertain Viability Ultrasound
My staff is telling me that I am getting reimbursed for the first sonogram and OB visit (using ICD 10 code for pregnancy of uncertain viability – O36.80X0. View the AnswerPregnancy Ultrasound
Our practice does routine ultrasounds (sac check- 76817) at the end of an IVF cycle and bill with a diagnosis code O09.081, pregnancy resulting from ART. View the AnswerPsychological Evaluation
Many REs require patients (and their spouses/partners) who are considering using donor gametes to see an infertility counselor first. View the AnswerInfertility Consult
Does ASRM have any examples of evaluation and management documentation for patients being seen for an initial infertility evaluation? View the AnswerInfertility Consult by Nurse
What code is used for a nurse practitioner seeing a fertility patient for the first time? View the AnswerInitial Visit for Infertility With No Mandated Coverage
What code would be appropriate for an initial visit for infertility? View the AnswerMonitoring E&M
Our group would like to know if others are billing an evaluation and management code for ultrasound and blood draw visits? View the AnswerNew vs Established Patient
How soon can you bill as a new infertility patient? View the AnswerGeneral E&M Consult
Recently we have received a “re-code” on a new patient (we billed a 99203 and the insurance re-coded it to a 99213). View the AnswerHysteroscopy Recurrent Implantation Failure
What is the appropriate ICD-10 code for recurrent implantation failure? View the AnswerD&C Under Ultrasound Guidance
What are the CPT codes and ICD-10 codes for coding a surgical case for a patient with history of Stage B adenocarcinoma of the cervix ... View the AnswerDiagnosis of Infertility for IVF Procedure
How important is it to have accurate documentation of the type of infertility diagnosis for IVF procedures? View the AnswerDiagnostic Testing of an Infertile Couple
The Z31.41 is or is not the correct code to use for diagnostic testing of an infertile couple? And If so can if be used as the primary and only code? View the AnswerBlood Draws
If a patient comes in only for a blood draw (venipuncture) and is seen only by the lab technician (not an MD, PA, or NP), may we bill for a (minimal) office visit? View the AnswerBlood Tests
Patients are requesting to have lab work drawn from the female patient moved to the males account due to the female fertility coverage being maxed out. View the AnswerMale Infertility
A summary of common codes for Male Infertility compiled by the ASRM Coding Committee. View the Coding SummaryASRM müllerian anomalies classification 2021
The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability. View the Committee OpinionIntracytoplasmic sperm injection (ICSI) for non–male factor indications: a committee opinion (2020)
Intracytoplasmic sperm injection is frequently used in combination with assisted reproductive technologies. View the Committee DocumentMoving innovation to practice: an Ethics Committee opinion (2021)
The introduction of new strategies, tests, and procedures into clinical practice raises challenging ethical issues. View the Committee OpinionFertility evaluation of infertile women: a committee opinion (2021)
Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner. View the Committee OpinionFertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion (2019)
The Ethics Committee recommends that in vitro fertilization (IVF) centers develop patient-centered policies regarding requests for futile treatment. View the Committee OpinionUse of exogenous gonadotropins for ovulation induction in anovulatory women: a committee opinion (2020)
Pretreatment evaluation, indications, treatment regimens, and complications of gonadotropin treatment. View the Committee OpinionReproductive and hormonal considerations in women at increased risk for hereditary gynecologic cancers: Society of Gynecologic Oncology and American Society for Reproductive Medicine Evidence-Based Review (2019)
Providers who care for women at risk for hereditary gynecologic cancers must consider the impact of these conditions. View the Joint StatementGuidance for Providers Caring for Women and Men Of Reproductive Age with Possible Zika Virus Exposure (Updated 2019)
This ASRM guidance specifically addresses Zika virus infection issues and concerns of individuals undergoing assisted reproductive technologies (ART). View the GuidelineAmerican Society for Reproductive Medicine position statement on uterus transplantation: a committee opinion (2018)
Following the birth of the first child from a transplanted uterus in Gothenburg, Sweden, in 2014, other centers worldwide have produced scientific reports. View the Committee OpinionChild-rearing ability and the provision of fertility services: an Ethics Committee opinion (2017)
Fertility programs may withhold services on the basis that patients will be unable to provide minimally adequate or safe care for offspring. View the Committee OpinionRemoval of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline (2017)
This review evaluates if uterine myomas impact likelihood of pregnancy and pregnancy loss, and if myomectomy influences pregnancy outcomes. View the GuidelineImproving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement (2014)
Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public. View the GuidelineTopic Resources
Billing for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the AnswerFertility and Sterility On Air - Unplugged: September 2024
Topics include: radiofrequency ablation of fibroids, testing embryos to reduce diabetes risk, preeclampsia risk with abnormal semen analysis, and more. Listen to the EpisodeJournal Club Global en Espanol: Actualizacion sobre el síndrome de ovario poliquístico
Fertility & Sterility se enorgullece de traer un Journal Club Global en Español en vivo desde Cancún, Mexico View the VideoCurrent evaluation of amenorrhea: a committee opinion (2024)
Amenorrhea is the absence or abnormal cessation of the menses. View the Educational BulletinFertility and Sterility On Air - Unplugged: May 2024
Topics include: counseling on pregnancy complications in PCOS patients, sorting early spermatocytes from testicular biopsies, and more. Listen to the EpisodeFertility and Sterility On Air - Unplugged: April 2024
Topics include: IVF in film, a rat model of fallopian tube torsion, comparing letrozole regimens for PCOS, and a review of chronic endometritis. Listen to the EpisodeRecommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023)
What is the recommended assessment and management of those with polycystic ovary syndrome (PCOS). View the RecommendationSurgery Coding
I took the ASRM coding course, and in that course, coding for bilateral neosalpingostomies was coded using only a dx of N70.11 (hydrosalpinx). View the AnswerOvulation Induction Monitoring With PCOS
We have a patient insisting that we code the ultrasound follicle monitoring with the PCOS diagnosis. View the AnswerCoding for Ovarian Drilling
Can you provide some information related to ovarian drilling that would assist non-physician administration (coders, billers)? View the AnswerPCOS
A summary of codes for PCOS as compiled by the ASRM Coding Committee. View the Coding SummaryBest practices of ASRM and ESHRE: a journey through reproductive medicine (2012)
ASRM and ESHRE are the two largest societies in the world whose members comprise the major experts and professionals working in reproductive medicine. View the Committee Joint GuidelineConsensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ ASRM-Sponsored 3rd PCOS Consensus Workshop Group (2012)
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females, with a high prevalence. View the Committee GuidelineTopic Resources
Appropriate Use of Modifier -25
Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the AnswerBilling for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the AnswerASRM on Increased Availability of Fertility Coverage for Federal Employees
We are pleased with the news shared by OPM today showing more carriers will be providing infertility benefits to federal employees in the coming year.
View the Press ReleaseNation’s Leading Professional Group for Fertility Care Professionals Calls for Passage of Right to IVF Act
ASRM applauds Majority Leader Schumer’s decision to seek reconsideration of the Right to IVF Act.
View the Press ReleaseBilling Physician vs Service Physician
What physician’s name must be on the treatment notes and who we are permitted to bill to insurance for: View the AnswerASRM announces support for HOPE with Fertility Services Act
The American Society for Reproductive Medicine is proud to endorse the HOPE with Fertility Services Act (HR 8821).
View the Press ReleaseASRM Responds to Senate Vote on IVF Bill
ASRM is disappointed that a filibuster prevented the passage of the Right to IVF Act.
View the Press ReleaseASRM Calls for Passage of Family Building Bill
It would increase access to IVF treatments for all Americans, including active-duty service members, veterans, and federal employees.
View the Press Release