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? 

ICD-9 code for recurrent implantation failure

Posted February 10, 2014

What is the appropriate ICD-9 code for recurrent implantation failure? The provider performed a diagnostic hysteroscopy for a patient with recurrent implantation failure.

Does an REI have to code the initial consult as infertility prior to making the diagnosis?

Posted July 16, 2013

Often, a patient comes to the office on her own or is referred for a consultation by her OB/GYN to the REI office for "infertility" prior to any evaluation.  Is it necessary to use an infertility code (ICD 628.XX) for this visit?  What if she has irregular menses, suspected PCOS, galactorrhea, hypothyroidism, ovulatory dysfunction, etc.?  We are getting more than a few denials, or patients who are canceling their consult because they have no "infertility coverage", before a proper diagnosis is made.

To me this is analogous to someone going to the emergency room complaining of chest pain and saying they are having a heart attack.  When it turns out to be heartburn, the ER physicians do not bill for myocardial infarction.

Coding for Patient Visits to Discuss Fertility Options without Known or Suspected Infertility

Posted July 23, 2012

We are seeing a lot of patients coming in to just discuss the fertility options available to them.  They are not necessarily infertile.  We have been using ICD9 code V26.89.  Do you recommend that we utilize any other ICD 9 codes?  If so, which ones?

Updates to CPT code set for 2012

Posted May 21, 2012

The Current Procedural Terminology code set (4th Edition) for 2012 has several updates of interest to practitioners in the field of reproductive endocrinology and infertility. HIPAA requirements dictate that insurers must accept new codes beginning January 1, 2012, although April 1st is commonly observed as the date when new CPT changes go into effect.

New, Expanded, And Revised ICD-9-CM Codes, Effective October 1, 2011

Posted September 1, 2011

The following are new, expanded, and revised ICD-9-CM codes that are of interest to practitioners in the field of Reproductive Medicine. These codes will take effect October 1, 2011. HIPAA requires providers to use the medical code set that is valid at the time the service is provided. Therefore, physicians must cease using discontinued codes for services after the new codes become effective October 1, 2011.

New, Expanded & Revised ICD-9-CM Codes, Effective October 1, 2009

Posted December 3, 2009

Following are new, expanded, and revised ICD-9-CM codes that are of interest to ASRM members and taking effect October 1. HIPAA requires providers to use the medical code set that is valid at the time the service is provided. New fertility preservation counseling and procedure codes have been developed that recognize that more and more patients are living longer after a cancer diagnosis and yet, some types of cancer treatment can affect a person's ability to conceive a child or maintain a pregnancy. The American Society for Reproductive Medicine, in collaboration with ACOG, has developed codes for encounters to preserve fertility before and after cancer treatments.

Procreative Management

Posted March 23, 2009

New ICD-9 codes for 2008: Natural family planning for contraceptive and procreative management.

Fertility Preservation

Posted March 22, 2009

I was wondering how to code for a consultation regarding fertility preservation options when an oncologist sends the patient. In addition, after the consult, if a patient chooses to go through an IVF cycle with embryo cryopreservation, what diagnosis should be used?  


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