Embryo Culture Denied As Experimental
We have received denials from insurance payers when billing CPT code 89251. The denial indicates “experimental in nature, not FDA approved.” I understand that CPT codes are not approved by FDA, but by the AMA. Can you advise with appealing this denial?
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Coding Q&A
View more Coding Q&A in this category
Billing for Ultrasounds and Labs
When billing for ultrasounds and labs, is it necessary
Use of Code 99211 for a Monitoring Appointment
Is it appropriate to use code 99211 if a patient is scheduled for a monitoring visit
Appropriate Use of Modifier -25
Is Modifier -25 appropriate in the monitoring cycle when an ultrasoundCoding Corner
Coding Corner is segmented into the following sections. Click an image below to view questions and answers in that section.
More Resources
ASRM Ethics Opinions
Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.
Practice Guidance
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.
ASRM Practice Documents
These guidelines have been developed by the ASRM Practice Committee to assist physicians with clinical decisions regarding the care of their patients.
ASRM Academy on the Go
ASRM MAC Tool 2021
The ASRM Müllerian Anomaly Classification 2021 (MAC2021) includes cervical and vaginal anomalies and standardize terminology within an interactive tool format.
Practice Guidance
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.
Practice Guidance
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 Ethics Opinions
Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.
Practice Guidance
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.
ASRM Practice Documents
These guidelines have been developed by the ASRM Practice Committee to assist physicians with clinical decisions regarding the care of their patients.
ASRM Academy on the Go
ASRM MAC Tool 2021
The ASRM Müllerian Anomaly Classification 2021 (MAC2021) includes cervical and vaginal anomalies and standardize terminology within an interactive tool format.
Practice Guidance
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.
Practice Guidance
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 Ethics Opinions
Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.
Practice Guidance
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
View more on the topic of embryo
Blastocyst culture and transfer in clinically assisted reproduction: a committee opinion (2018)
The purposes of this document is to review the literature regarding the clinical application of blastocyst transfer. View the Committee Opinion
Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion (2018)
Posthumous gamete retrieval or use is ethically justifiable if written documentation from the deceased authorizing the procedure is available. View the Committee Opinion
Recommended practices for the management of embryology, andrology, and endocrinology laboratories: a committee opinion (2014)
A general overview for good management practices within the endocrinology, andrology, and embryology laboratories in the United States. View the Recommendation
ASRM EDGE Tool
Get the EDGE on your fellow Embryologists! As the grading of embryos varies within IVF laboratories and between laboratories, EDGE allows you to compare yourself against embryologists in the US and around the world. Learn more about the EDGE Tool
Transfer of embryos affected by monogenic conditions: an Ethics Committee Opinion (2025)
Patient requests to transfer embryos with serious monogenic disorders detected in preimplantation testing are rare; this opinion discusses physician responses. View the Committee Opinion
Disclosure of medical errors and untoward events involving gametes and embryos: an Ethics Committee opinion (2024)
Medical providers have an ethical duty to disclose clinically significant errors involving gametes and embryos. View the Committee Opinion
How to bill for an FET
Is there a new update to the 89272 code that allows its use without View the Answer
Codes for Embryo Biopsy
When doing a preimplantation genetic test (PGT) biopsy, can you bill for each day a biopsy is performed or can you only bill once for the cycle? View the Answer
Billing for assisted hatching at biopsy and transfer
We would also like to know if you can bill assisted hatching with biopsy and then assisted hatching again during the transfer cycle. View the Answer
Shipping of frozen embryos
I have some infertility coverage, under which my insurance said they will cover frozen embryo shipping/transport from one facility to another. View the Answer
Clinical management of mosaic results from preimplantation genetic testing for aneuploidy of blastocysts: a committee opinion (2023)
This document incorporates studies about mosaic embryo transfer and provides evidence-based considerations for embryos with mosaic results on PGT-A. View the Committee Opinion
How to EDGE
Explore the ASRM EDGE tool for embryo grading. Learn grading steps, view dashboards, and assign blastocyst grades using the SART and Gardner scales in ASRM Academy. View the ASRMed Talk Video
Journal Club Global: Transferencia de embriones frescos versus congelados: ¿Cuál es la mejor opción
Los resultados de nuevas técnicas de investigación clínica que utilizan información de bancos nacionales de vigilancia médica. View the Video
Defining embryo donation: an Ethics Committee opinion (2023)
The ethical appropriateness of patients donating embryos to other patients for family building, or for research, is well established.
View the Committee Opinion
Does the number of eggs being frozen matter?
There is currently only one CPT code for the cryopreservation of mature oocytes and embryos. View the Answer
Reproductive Tissue Storage
What are the CPT codes for the Storage of Reproductive Cells/Tissues? View the Answer
ICSI and Embryo Biopsy
How to bill for ICSI or embryo biopsies that occur in different days? View the Answer
Lab RVUs
Is there a list of RVUs for embryology and andrology laboratory procedures, and if so, where can it be found? View the Answer
Embryo Biopsy
Have any new codes been introduced for the lab portion of PGT? View the Answer
Embryo Biopsy Embryologist Travel Costs
Can we bill insurance for the biopsy procedure? Can we bill for travel expenses? View the Answer
Embryo Biopsy PGS Testing
What codes are appropriate for PGS testing? View the Answer
Embryo Co-culture
Can codes 89250 and 89251 be billed on different days of the same cycle? View the Answer
Embryo Culture Denied As Experimental
We have received denials from insurance payers when billing CPT code 89251. View the Answer
Embryo Culture Less Than And More Than Four Days
When coding 89250 culture of oocytes/embryo <4 days, should that code be submitted to the insurance company for each of the days? View the Answer
Embryo Storage Fees For Multiple Cycles
We bill embryo storage 89342 for a year's storage. View the Answer
Embryo Thawing/Warming
Is it allowable to bill 89250 for the culture of embryos after thaw for a frozen embryo transfer (FET) cycle? View the Answer
Gamete Thawing/Warming
Can patients be charged for each vial/straw of reproductive gametes or tissues thawed? View the Answer
D&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 Answer
Assisted Hatching Billed With Embryo Biopsy
Do you know if both assisted hatching (89253) and embryo biopsy for PGS/PGD/CCS (89290/89291) can be billed during the same cycle? View the Answer
Assisted Zona Hatching
Can assisted hatching and embryo biopsy for PGT-A; PGT-M or PGT-SR be billed during the same cycle? View the Answer
Billing For Cryopreservation Of Embryos Under The Male Partner
Can 89258 be billed under the male partner of a female patient? View the Answer
Embryo Transfer
A summary of Embryo Transfer codes collected by the ASRM Coding Committee View the Coding Summary
Journal Club Global: Is PGT-P cutting edge or should we cut it out?
PGT for polygenic risk scoring (PGT-P) is a novel screening strategy of embryos for polygenic conditions and traits. View the Video
Disposition of unclaimed embryos: an Ethics Committee opinion
Programs should create and enforce written policies addressing the designation, retention, and disposal of unclaimed embryos. View the Committee Opinion
A review of best practices of rapid-cooling vitrification for oocytes and embryos: a committee opinion (2021)
The focus of this paper is to review best practices for rapid-cooling cryopreservation of oocytes and embryos. View the Committee Opinion
Ethics in embryo research: a position statement by the ASRM Ethics in Embryo Research Task Force and the ASRM Ethics Committee (2020)
Scientific research using human embryos advances human health and offspring well-being and provides vital insights into the mechanisms for reproduction. View the Committee Opinion
Guidance 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 Guideline
Blastocyst culture and transfer in clinically assisted reproduction: a committee opinion (2018)
The purposes of this document is to review the literature regarding the clinical application of blastocyst transfer. View the Committee Opinion
Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion (2018)
Posthumous gamete retrieval or use is ethically justifiable if written documentation from the deceased authorizing the procedure is available. View the Committee Opinion
Recommended practices for the management of embryology, andrology, and endocrinology laboratories: a committee opinion (2014)
A general overview for good management practices within the endocrinology, andrology, and embryology laboratories in the United States. View the Recommendation
ASRM EDGE Tool
Get the EDGE on your fellow Embryologists! As the grading of embryos varies within IVF laboratories and between laboratories, EDGE allows you to compare yourself against embryologists in the US and around the world. Learn more about the EDGE Tool
Transfer of embryos affected by monogenic conditions: an Ethics Committee Opinion (2025)
Patient requests to transfer embryos with serious monogenic disorders detected in preimplantation testing are rare; this opinion discusses physician responses. View the Committee Opinion
Disclosure of medical errors and untoward events involving gametes and embryos: an Ethics Committee opinion (2024)
Medical providers have an ethical duty to disclose clinically significant errors involving gametes and embryos. View the Committee Opinion
How to bill for an FET
Is there a new update to the 89272 code that allows its use without View the Answer
Codes for Embryo Biopsy
When doing a preimplantation genetic test (PGT) biopsy, can you bill for each day a biopsy is performed or can you only bill once for the cycle? View the Answer
Billing for assisted hatching at biopsy and transfer
We would also like to know if you can bill assisted hatching with biopsy and then assisted hatching again during the transfer cycle. View the Answer
Shipping of frozen embryos
I have some infertility coverage, under which my insurance said they will cover frozen embryo shipping/transport from one facility to another. View the Answer
Clinical management of mosaic results from preimplantation genetic testing for aneuploidy of blastocysts: a committee opinion (2023)
This document incorporates studies about mosaic embryo transfer and provides evidence-based considerations for embryos with mosaic results on PGT-A. View the Committee Opinion
How to EDGE
Explore the ASRM EDGE tool for embryo grading. Learn grading steps, view dashboards, and assign blastocyst grades using the SART and Gardner scales in ASRM Academy. View the ASRMed Talk Video
Journal Club Global: Transferencia de embriones frescos versus congelados: ¿Cuál es la mejor opción
Los resultados de nuevas técnicas de investigación clínica que utilizan información de bancos nacionales de vigilancia médica. View the Video
Defining embryo donation: an Ethics Committee opinion (2023)
The ethical appropriateness of patients donating embryos to other patients for family building, or for research, is well established.
View the Committee Opinion
Does the number of eggs being frozen matter?
There is currently only one CPT code for the cryopreservation of mature oocytes and embryos. View the Answer
Reproductive Tissue Storage
What are the CPT codes for the Storage of Reproductive Cells/Tissues? View the Answer
ICSI and Embryo Biopsy
How to bill for ICSI or embryo biopsies that occur in different days? View the Answer
Lab RVUs
Is there a list of RVUs for embryology and andrology laboratory procedures, and if so, where can it be found? View the Answer
Embryo Biopsy
Have any new codes been introduced for the lab portion of PGT? View the Answer
Embryo Biopsy Embryologist Travel Costs
Can we bill insurance for the biopsy procedure? Can we bill for travel expenses? View the Answer
Embryo Biopsy PGS Testing
What codes are appropriate for PGS testing? View the Answer
Embryo Co-culture
Can codes 89250 and 89251 be billed on different days of the same cycle? View the Answer
Embryo Culture Denied As Experimental
We have received denials from insurance payers when billing CPT code 89251. View the Answer
Embryo Culture Less Than And More Than Four Days
When coding 89250 culture of oocytes/embryo <4 days, should that code be submitted to the insurance company for each of the days? View the Answer
Embryo Storage Fees For Multiple Cycles
We bill embryo storage 89342 for a year's storage. View the Answer
Embryo Thawing/Warming
Is it allowable to bill 89250 for the culture of embryos after thaw for a frozen embryo transfer (FET) cycle? View the Answer
Gamete Thawing/Warming
Can patients be charged for each vial/straw of reproductive gametes or tissues thawed? View the Answer
D&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 Answer
Assisted Hatching Billed With Embryo Biopsy
Do you know if both assisted hatching (89253) and embryo biopsy for PGS/PGD/CCS (89290/89291) can be billed during the same cycle? View the Answer
Assisted Zona Hatching
Can assisted hatching and embryo biopsy for PGT-A; PGT-M or PGT-SR be billed during the same cycle? View the Answer
Billing For Cryopreservation Of Embryos Under The Male Partner
Can 89258 be billed under the male partner of a female patient? View the Answer
Embryo Transfer
A summary of Embryo Transfer codes collected by the ASRM Coding Committee View the Coding Summary
Journal Club Global: Is PGT-P cutting edge or should we cut it out?
PGT for polygenic risk scoring (PGT-P) is a novel screening strategy of embryos for polygenic conditions and traits. View the Video
Disposition of unclaimed embryos: an Ethics Committee opinion
Programs should create and enforce written policies addressing the designation, retention, and disposal of unclaimed embryos. View the Committee Opinion
A review of best practices of rapid-cooling vitrification for oocytes and embryos: a committee opinion (2021)
The focus of this paper is to review best practices for rapid-cooling cryopreservation of oocytes and embryos. View the Committee Opinion
Ethics in embryo research: a position statement by the ASRM Ethics in Embryo Research Task Force and the ASRM Ethics Committee (2020)
Scientific research using human embryos advances human health and offspring well-being and provides vital insights into the mechanisms for reproduction. View the Committee Opinion
Guidance 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 Guideline
Blastocyst culture and transfer in clinically assisted reproduction: a committee opinion (2018)
The purposes of this document is to review the literature regarding the clinical application of blastocyst transfer. View the Committee Opinion
Posthumous retrieval and use of gametes or embryos: an Ethics Committee opinion (2018)
Posthumous gamete retrieval or use is ethically justifiable if written documentation from the deceased authorizing the procedure is available. View the Committee Opinion
Recommended practices for the management of embryology, andrology, and endocrinology laboratories: a committee opinion (2014)
A general overview for good management practices within the endocrinology, andrology, and embryology laboratories in the United States. View the Recommendation
ASRM EDGE Tool
Get the EDGE on your fellow Embryologists! As the grading of embryos varies within IVF laboratories and between laboratories, EDGE allows you to compare yourself against embryologists in the US and around the world. Learn more about the EDGE ToolTopic Resources
View more on the topic of insurance
Jan 2022: Modifier 93 – Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
At the September 2021 CPT Editorial Panel Meeting, a new Modifier was accepted to describe real-time telemedicine services. View the Letter
Feb 2021: CMS holds physicians harmless from Merit-based Incentive Payment System (MIPS) penalties amid COVID-19 Public Health Emergency
CMS announced it will hold physicians harmless from up to 9% MIPS penalties due to the significant disruptions of the COVID-19 public health emergency. View the Letter
Jan 2021: Coding for COVID-19 Vaccine Administration
AMA has published an update to the Current Procedural Terminology (CPT®) code set that includes new vaccine-specific codes to report immunizations. View the Letter
Jan 2021: Telehealth Coding Extension and 2021 Medicare Physician Fee Schedule
Effective January 11, 2021, the U.S. Department of Health and Human Services' Secretary Azar has extended the COVID-19 Public Health Emergency (PHE). View the Letter
Dec 2020: New Evaluation and Management Codes for 2021
Effective January 1, 2021, Evaluation and Management Codes will be changed for office visits only. View the Link
The Heart of Advocacy Day
Advocacy is a commitment to push through discomfort for the sake of future progress. Learn more about RESOLVE's Advocacy Day in partnership with ASRM.
ASRM Releases Statement on IVF Policy Priorities
ASRM advocates for expanded IVF access, urging policy solutions that prioritize patient care, inclusivity, and medical decision-making free from political interference. View the Press Release
Just the Facts: IVF Policy Priorities
ASRM advocates for expanded IVF access, urging policy solutions that prioritize patient care, inclusivity, and medical decision-making free from political interference. View the advocacy resource
ASRM responds to Trump Executive Order on IVF
ASRM welcomes Trump’s Executive Order on IVF, urging mandated insurance coverage and federal employee access to fertility care.
Billing for Ultrasounds and Labs
When billing for ultrasounds and labs, is it necessary View the Answer
Use of Code 99211 for a Monitoring Appointment
Is it appropriate to use code 99211 if a patient is scheduled for a monitoring visit View the Answer
HyCoSy Bundled Code 0568T
When billing for HyCoSy, should the new code 0568T View the Answer
Appropriate Use of Modifier -25
Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the Answer
Billing for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the Answer
Billing 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 Answer
Mandated states and egg retrieval
What name should you use to submit for reimbursement for the actual egg donor when there is benefit for the donor egg retrieval? View the Answer
Billing 58558 together with 58560
Can CPT codes 58558 and 58560 be billed together? Also, can 58560 be billed with place of service 11? View the Answer
IVF 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 Answer
Cycle coordination fees and 99499, S4042
I reviewed cycle coordination fees, but see that there is no specific code for cycle management. View the Answer
Reimbursement for cost of donor egg
My wife and I are going through a fertility treatment process, and we have purchased a donor egg out-of-pocket from a donor bank. View the Answer
Coding for Ovarian tissue cryopreservation, experimental or not?
For Cryopreservation; Reproductive Tissue Ovarian- 0058T code is not being recognized. Is there an updated one being used or a replacement of this code? View the Answer
Supervising provider for embryology billing
We typically bill our IVF Lab work under the rendering provider who performs the VOR. Who should be the supervising provider for embryology billing? View the Answer
Billing 58558 and 58560 together
Can CPT codes 58558 and 58560 be billed together? Also, can 58560 be billed with place of service 11? View the Answer
Endometrioma
Surgery was performed under anesthesia for Aspiration of right hyrosalpinx fluid and right endometrioma. View the Answer
Total versus Free estradiol
Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? View the Answer
Unlisted Fertility Treatment CPT Code
Can you please refer me to an unlisted management CPT code for fertility treatment? View the Answer
Vitamin D Testing in Infertility Patients
We are being told that, as of this year, vitamin D level screening is not being covered by many insurers. View the Answer
Z Codes Vs. Procedure Codes For Fertility Preservation Counseling
I am trying to understand better when to use the procreative management code vs the fertility preservation counseling and procedure codes. View the Answer
ICD-10 Code For Intrauterine Insemination (IUI) For Same-Sex Couple
Which ICD-10 code you recommend for IUI same gender couples? View the Answer
Initial Visit for Infertility With No Mandated Coverage
What code would be appropriate for an initial visit for infertility? View the Answer
Non-REI Board Certified MD Performing REI Procedures
My boss has a few follow up questions about a non-REI board certified MD performing REI procedures. View the Answer
Embryo Culture Denied As Experimental
We have received denials from insurance payers when billing CPT code 89251. View the Answer
Flat Fee For Outside Monitoring
Can our office charge outside monitoring patients a flat fee to be seen? View the Answer
Frozen Embryo Transport
What is the code for the cost of frozen embryo transport? View the Answer
Global Billing Vs Billing Under Provider
For an IVF cycle (that is not being billed global to an insurance plan) is it appropriate to bill the charges under one “global” provider? View the Answer
Diagnosis Codes For Intrauterine Insemination (IUI)
I was reviewing your Coding Corner information to find a definitive diagnosis for IUI procedures. Which diagnosis is the most appropriate? View the Answer
Donor Egg-Retrieval On Recipient's Claim
Is the donor egg retrieval included on the bill to insurance with the first IVF treatment for the recipient? View the Answer
Board Certified Vs. Non-Board Certified Billing
Is coding/billing any different when a non-board certified or non-REI provider submits for REI procedure? View the Answer
Claim Form for Donor Egg Retrieval
What bill form is used of IVF donor egg retrieval? View the Answer
Coding For Alpha-Fetoprotein Testing
My clinic is looking into implementing Alpha-Fetoprotein (AFP) testing. I understand there is currently no CPT code listed for this testing. View the Answer
Coding For Donor Egg Retrieval For Male Intended Parent
In coding a donor-egg retrieval to bill to insurance under the male intended parent, would it be appropriate to use the Z31.83? View the Answer
Billing at an Outside Clinic for Lab Services
One of my physicians uses an outside facility to perform the retrievals and transfers. View the Answer
Billing For Cryopreservation Of Embryos Under The Male Partner
Can 89258 be billed under the male partner of a female patient? View the Answer
Billing For Procedures Performed By Outside Physicians
Our physician tested positive for COVID-19, so another physician not associated with our office performed our egg retrievals and embryo transfers. View the Answer
Male Infertility
A summary of common codes for Male Infertility compiled by the ASRM Coding Committee. View the Coding Summary
Mental-health Services During Assisted Reproduction
A summary of codes for Mental-health Services During Assisted Reproduction compiled by the ASRM Coding Committee. View the Coding Summary
PCOS
A summary of codes for PCOS as compiled by the ASRM Coding Committee. View the Coding Summary
Recurrent Pregnancy Loss (RPL)
Strategy for coding for a patient with RPL - codes compiled by the ASRM Coding Committee. View the Coding Summary
Laboratory Procedures during ART Cycles
A listing of codes, compiled for a fresh ART cycle, transfer, biopsy, cryopreservation of embryos and oocytes, storage, and thawing. View the Coding Summary
Embryo Transfer
A summary of Embryo Transfer codes collected by the ASRM Coding Committee View the Coding Summary
Endometriosis
A summary of common codes for Endometriosis compiled by the ASRM Coding Committee View the Coding Summary
Fibroids
A summary of codes to use with fibroids and myomas compiled by the ASRM Coding Committee View the Coding Summary
Fertility Preservation
A summary of codes for Fertility Preservation compiled by the ASRM Coding Committee. View the Coding Summary
Jan 2022: Modifier 93 – Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
At the September 2021 CPT Editorial Panel Meeting, a new Modifier was accepted to describe real-time telemedicine services. View the Letter
Feb 2021: CMS holds physicians harmless from Merit-based Incentive Payment System (MIPS) penalties amid COVID-19 Public Health Emergency
CMS announced it will hold physicians harmless from up to 9% MIPS penalties due to the significant disruptions of the COVID-19 public health emergency. View the Letter
Jan 2021: Coding for COVID-19 Vaccine Administration
AMA has published an update to the Current Procedural Terminology (CPT®) code set that includes new vaccine-specific codes to report immunizations. View the Letter
Jan 2021: Telehealth Coding Extension and 2021 Medicare Physician Fee Schedule
Effective January 11, 2021, the U.S. Department of Health and Human Services' Secretary Azar has extended the COVID-19 Public Health Emergency (PHE). View the Letter
Dec 2020: New Evaluation and Management Codes for 2021
Effective January 1, 2021, Evaluation and Management Codes will be changed for office visits only. View the Link
The Heart of Advocacy Day
Advocacy is a commitment to push through discomfort for the sake of future progress. Learn more about RESOLVE's Advocacy Day in partnership with ASRM.
ASRM Releases Statement on IVF Policy Priorities
ASRM advocates for expanded IVF access, urging policy solutions that prioritize patient care, inclusivity, and medical decision-making free from political interference. View the Press Release
Just the Facts: IVF Policy Priorities
ASRM advocates for expanded IVF access, urging policy solutions that prioritize patient care, inclusivity, and medical decision-making free from political interference. View the advocacy resource
ASRM responds to Trump Executive Order on IVF
ASRM welcomes Trump’s Executive Order on IVF, urging mandated insurance coverage and federal employee access to fertility care.
Billing for Ultrasounds and Labs
When billing for ultrasounds and labs, is it necessary View the Answer
Use of Code 99211 for a Monitoring Appointment
Is it appropriate to use code 99211 if a patient is scheduled for a monitoring visit View the Answer
HyCoSy Bundled Code 0568T
When billing for HyCoSy, should the new code 0568T View the Answer
Appropriate Use of Modifier -25
Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the Answer
Billing for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the Answer
Billing 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 Answer
Mandated states and egg retrieval
What name should you use to submit for reimbursement for the actual egg donor when there is benefit for the donor egg retrieval? View the Answer
Billing 58558 together with 58560
Can CPT codes 58558 and 58560 be billed together? Also, can 58560 be billed with place of service 11? View the Answer
IVF 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 Answer
Cycle coordination fees and 99499, S4042
I reviewed cycle coordination fees, but see that there is no specific code for cycle management. View the Answer
Reimbursement for cost of donor egg
My wife and I are going through a fertility treatment process, and we have purchased a donor egg out-of-pocket from a donor bank. View the Answer
Coding for Ovarian tissue cryopreservation, experimental or not?
For Cryopreservation; Reproductive Tissue Ovarian- 0058T code is not being recognized. Is there an updated one being used or a replacement of this code? View the Answer
Supervising provider for embryology billing
We typically bill our IVF Lab work under the rendering provider who performs the VOR. Who should be the supervising provider for embryology billing? View the Answer
Billing 58558 and 58560 together
Can CPT codes 58558 and 58560 be billed together? Also, can 58560 be billed with place of service 11? View the Answer
Endometrioma
Surgery was performed under anesthesia for Aspiration of right hyrosalpinx fluid and right endometrioma. View the Answer
Total versus Free estradiol
Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? View the Answer
Unlisted Fertility Treatment CPT Code
Can you please refer me to an unlisted management CPT code for fertility treatment? View the Answer
Vitamin D Testing in Infertility Patients
We are being told that, as of this year, vitamin D level screening is not being covered by many insurers. View the Answer
Z Codes Vs. Procedure Codes For Fertility Preservation Counseling
I am trying to understand better when to use the procreative management code vs the fertility preservation counseling and procedure codes. View the Answer
ICD-10 Code For Intrauterine Insemination (IUI) For Same-Sex Couple
Which ICD-10 code you recommend for IUI same gender couples? View the Answer
Initial Visit for Infertility With No Mandated Coverage
What code would be appropriate for an initial visit for infertility? View the Answer
Non-REI Board Certified MD Performing REI Procedures
My boss has a few follow up questions about a non-REI board certified MD performing REI procedures. View the Answer
Embryo Culture Denied As Experimental
We have received denials from insurance payers when billing CPT code 89251. View the Answer
Flat Fee For Outside Monitoring
Can our office charge outside monitoring patients a flat fee to be seen? View the Answer
Frozen Embryo Transport
What is the code for the cost of frozen embryo transport? View the Answer
Global Billing Vs Billing Under Provider
For an IVF cycle (that is not being billed global to an insurance plan) is it appropriate to bill the charges under one “global” provider? View the Answer
Diagnosis Codes For Intrauterine Insemination (IUI)
I was reviewing your Coding Corner information to find a definitive diagnosis for IUI procedures. Which diagnosis is the most appropriate? View the Answer
Donor Egg-Retrieval On Recipient's Claim
Is the donor egg retrieval included on the bill to insurance with the first IVF treatment for the recipient? View the Answer
Board Certified Vs. Non-Board Certified Billing
Is coding/billing any different when a non-board certified or non-REI provider submits for REI procedure? View the Answer
Claim Form for Donor Egg Retrieval
What bill form is used of IVF donor egg retrieval? View the Answer
Coding For Alpha-Fetoprotein Testing
My clinic is looking into implementing Alpha-Fetoprotein (AFP) testing. I understand there is currently no CPT code listed for this testing. View the Answer
Coding For Donor Egg Retrieval For Male Intended Parent
In coding a donor-egg retrieval to bill to insurance under the male intended parent, would it be appropriate to use the Z31.83? View the Answer
Billing at an Outside Clinic for Lab Services
One of my physicians uses an outside facility to perform the retrievals and transfers. View the Answer
Billing For Cryopreservation Of Embryos Under The Male Partner
Can 89258 be billed under the male partner of a female patient? View the Answer
Billing For Procedures Performed By Outside Physicians
Our physician tested positive for COVID-19, so another physician not associated with our office performed our egg retrievals and embryo transfers. View the Answer
Male Infertility
A summary of common codes for Male Infertility compiled by the ASRM Coding Committee. View the Coding Summary
Mental-health Services During Assisted Reproduction
A summary of codes for Mental-health Services During Assisted Reproduction compiled by the ASRM Coding Committee. View the Coding Summary
PCOS
A summary of codes for PCOS as compiled by the ASRM Coding Committee. View the Coding Summary
Recurrent Pregnancy Loss (RPL)
Strategy for coding for a patient with RPL - codes compiled by the ASRM Coding Committee. View the Coding Summary
Laboratory Procedures during ART Cycles
A listing of codes, compiled for a fresh ART cycle, transfer, biopsy, cryopreservation of embryos and oocytes, storage, and thawing. View the Coding Summary
Embryo Transfer
A summary of Embryo Transfer codes collected by the ASRM Coding Committee View the Coding Summary
Endometriosis
A summary of common codes for Endometriosis compiled by the ASRM Coding Committee View the Coding Summary
Fibroids
A summary of codes to use with fibroids and myomas compiled by the ASRM Coding Committee View the Coding Summary
Fertility Preservation
A summary of codes for Fertility Preservation compiled by the ASRM Coding Committee. View the Coding Summary
Jan 2022: Modifier 93 – Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
At the September 2021 CPT Editorial Panel Meeting, a new Modifier was accepted to describe real-time telemedicine services. View the Letter
Feb 2021: CMS holds physicians harmless from Merit-based Incentive Payment System (MIPS) penalties amid COVID-19 Public Health Emergency
CMS announced it will hold physicians harmless from up to 9% MIPS penalties due to the significant disruptions of the COVID-19 public health emergency. View the Letter
Jan 2021: Coding for COVID-19 Vaccine Administration
AMA has published an update to the Current Procedural Terminology (CPT®) code set that includes new vaccine-specific codes to report immunizations. View the Letter
Jan 2021: Telehealth Coding Extension and 2021 Medicare Physician Fee Schedule
Effective January 11, 2021, the U.S. Department of Health and Human Services' Secretary Azar has extended the COVID-19 Public Health Emergency (PHE). View the Letter
