Diagnosis of Infertility

What is the ICD-9 code for oligo-ovulation

Posted December 17, 2013

What is the ICD-9 code for oligo-ovulation? If a patient is being seen for follicle tracking for HMG/TIC cycle with oligo-ovulation, is the ICD-9 code 628.0 (Infertility Anovulation)?

Can I use diagnosis codes for ovarian dysfunction for IUI or IVF

Posted December 17, 2013

Our practice would like some guidelines on whether other ovarian dysfunction (diagnosis code 256.8) or unspecified ovarian dysfunction (diagnosis code 256.9) can be used as the sole diagnosis code for an IUI or an IVF cycle.  Are the documentation requirements any different than just 628.9? 

More than one diagnosis code

Posted May 18, 2010

Several years ago, I took the ASRM coding course, and in that course, coding for bilateral neosalpingostomies was coded using only a dx of 614.1 (hydrosalpinx). Yet, for the office-based care of a patient with say, PCOS and infertility, both diagnoses were required for correct coding. Do you agree with either or both of these coding approaches, which seem inconsistent?

Billing for color flow Doppler

Posted May 18, 2010

I often use color flow Doppler ultrasound to identify the presence of blood flow.  For instance, I use Doppler to evaluate ovarian blood flow in women with abdominal pain, to look for a feeding vessel in women with a possible uterine polyp, to evaluate the presence of blood flow in an ovarian cyst, and sometimes to better define the ovarian borders.  Can I bill for the use of color flow Doppler to identify the presence of blood flow?  If so, what codes should we use?

Recurrent Pregnancy Loss Coding

Posted December 3, 2009

Our physicians have struggled with particular patients who have to pay for their infertility services (because as we all know, most insurance companies do not cover treatment of infertility) because the diagnosis is 628.9. There are very few patients who are not infertile but are actually RPL (629.81), and in their recurrent pregnancy loss work up, the only finding is progesterone deficiency. These patients will usually be prescribed Clomid to hopefully correct this deficiency and help a pregnancy last. With regard to the ovary checks and ultrasounds these patients have, what should their diagnosis code be -- 628.9 or 629.81? I am afraid if we bill it with a 629.81 to an insurance company and a policy pays on it and later requests records, we may get into trouble for insurance fraud. We know there are patients as well who have been diagnosed as 629.81 and have not been able to conceive again, and in these cases when Clomid is prescribed, we feel it is appropriate to bill with a 628.9 diagnosis code.  

Retrograde Semen Analysis

Posted June 12, 2009

Our physicians do the retrograde semen analysis. What CPT/CPTs would you suggest we use?

Existing Semen Analysis

Posted June 12, 2009

There are two new codes and revisions were made to the existing semen analysis codes to clarify their intent. The word "complete" was deleted from code 89320 to clarify that it is for a basic semen analysis that includes analysis of ejaculate volume and sperm count, motility and differential. The word "sperm" was added to code 89321 to make it clear that this test is for the presence and motility of sperm.

Bill for the Semen Analysis

Posted June 12, 2009

We frequently perform Strict Criteria Morphology alone (without semen analysis). What would be the appropriate code for that test?

Female Infertility

Posted June 12, 2009

If a husband has had a vasectomy, does the sterilization code apply to the wife's visits?

Bill for the Diagnosis Part of Procreative Management

Posted June 12, 2009

I am trying to get some guidance on the correct way to bill for the diagnosis part of Procreative Management. I understand that when a patient is going through the diagnostic portion of determining the reason for infertility, you would use the appropriate ICD.9 code to indicate the reasons for the test. My question is: Once we have determined that the patient is infertile, and we want to go ahead with the IVF process, would it be appropriate (is it required) to use the V26.9 code as the primary diagnosis and the reason for the infertility as the second diagnosis? The second part of my question is do you have some guidance on what else would be considered procreative management?

Infertility and the Etiology

Posted June 12, 2009

Reproductive Endocrinology/Infertility sub-specialists often evaluate a couple for infertility and know that the etiology may result from abnormalities in either or both partners. Since you provide services to both the husband and the wife, it is suggested that you also code separately on both partners.


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