Coding for an endometrial biopsy/Mock cycle
Our center has been performing Mock/ERA cycle for a few years now. Patients without IVF coverage are private pay for this cycle. Recently we have had patients request for us to bill their insurance for the two monitoring visits and the Endo BX and change the diagnosis code to something that is payable. We are coding these cycles with Z31.83 as this cycle is in regards to preparation for a frozen embryo transfer at some point. Patients are asking us to change the icd10 code to Z31.41 as a diagnostic testing cycle. Our consents that patient sign state “consenting to uterine preparation for upcoming IVF/FET/Pride cycle” and our op note on Endo bx (58100) states “patient present today for endo bx due to: Enhanced implantation”. We do get many requests from carriers for records.
An ERA cycle is performed the same way a patient prepares for a frozen embryo transfer (FET). However, rather than performing an actual embryo transfer, an endometrial biopsy is performed. The biopsy assesses whether the uterine lining would have been receptive if an embryo transfer was performed.
I do know that the lab that performs the diagnostic testing portion does not bill insurance as they will not cover it. I want to make sure that our center is coding correctly.
An ERA cycle is performed the same way a patient prepares for a frozen embryo transfer (FET). However, rather than performing an actual embryo transfer, an endometrial biopsy is performed. The biopsy assesses whether the uterine lining would have been receptive if an embryo transfer was performed.
I do know that the lab that performs the diagnostic testing portion does not bill insurance as they will not cover it. I want to make sure that our center is coding correctly.
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