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Coding Corner General teaser

Donor Egg Infectious Disease Lab Screening

The issue we are experiencing is outside labs billing with Z11.3 are getting denials stating improper ICD-10 for the services billed. Medicare guidelines are being quoted as stating the Z11.3 is not a proper principal diagnosis code. Do you have any suggestions/feedback on an additional/alternate diagnosis code? We are having difficulty finding one that is more appropriate. Thanks so much! 138828 Donor C. Trachomatis/N.Gonorrhoeae; 138930 Donor CMV Total w/Reflex to IgM and IgG; 138699 Donor HBcAb Total; 138749 Donor HBsAg w/Reflex to confirmatory neut. Assay; 138907 Donor HCV Ab; 138931 Donor HIV-1/HIV-2 Plus O w/ Reflex to HIV-1 WB; 138780 Donor HTLV-I/II Ab w/Reflex to Immunoblot; 139240 Donor Procleix Ultrio Assay; 139280 Donor Syphillis (T-Pallidum IgG); 139486 Sperm Donor Viromed Panel.

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Coding Q&A

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Coding Third Party teaser

Who to bill for gestational carrier services if intended parents have insurance?

I wanted to inquire about guidelines for billing services to a surrogate’s insurance company if intended parents purchased the insurance coverage. 
Coding Third Party teaser

Mental health assessment for donors and intended parents

Is it appropriate to use 96156 or 96167 for mental health professional (MHP) counseling of gamete/embryo donors and gestational carriers?
Coding Third Party teaser

Diagnosis code for donation

What is the diagnosis code for an embryo donation versus egg donation?
Coding Third Party teaser

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?

Coding Corner


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More Resources

Practice Committee Documents teaser

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.

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MAC 2021 teaser
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.

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Coding Corner general teaser
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.

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Topic Resources

View more on the topic of egg donation
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Fertility and Sterility On Air - TOC: Jan 2025

This episode of Fertility and Sterility On Air covers groundbreaking research on reproductive medicine, including PGTA in donor eggs, BMI effects, and ovarian transplantation. Listen to the Episode
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Fertility and Sterility On Air - TOC: Dec 2024

Podcast episode discussing reproductive medicine highlights, including ASRM 2024 insights, meta-analysis integrity, donor ethics, and IVF communication challenges. Listen to the Episode
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Fertility and Sterility On Air - TOC: November 2024

Explore insights on the latest Fertility and Sterility On Air podcast, discussing ART workups, LGBTQ family building, genetic screening, and original research. Listen to the Episode
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Hormonal Induction of Endometrial Receptivity for Fresh or Frozen Embryo Transfer​

Explore Dr. Paulson's insights on endometrial receptivity and hormonal preparation in IVF, egg donation, and surrogacy, highlighting estrogen and progesterone roles. View the ASRMed Talk Video
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Gamete and embryo donation guidance (2024)

Explore the latest guidelines for evaluating sperm, oocyte, and embryo donors and recipients. Includes FDA, CDC, and ASRM standards for optimal safety and outcomes.
 
 
View the Committee Document
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Mental health assessment for donors and intended parents

Is it appropriate to use 96156 or 96167 for mental health professional (MHP) counseling of gamete/embryo donors and gestational carriers? View the Answer

Topic Resources

View more on the topic of infectious disease
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Recommendations for reducing the risk of viral transmission during fertility treatment with the use of autologous gametes: a committee opinion (2023)

Sexually transmitted infections are of major concern to reproductive specialists. View the Committee Opinion
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Human immunodeficiency virus and infertility treatment: an Ethics Committee opinion (2021)

HIV is a serious but manageable chronic disease that affects persons of reproductive age, many of whom express a desire for biological parenthood. View the Committee Opinion
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COVID, Reproductive Health, and Public Policy

The recommendations detailed from the experience of the ASRM COVID-19 Task Force over the past 2 years can be used as a template to prepare for future public health threats. View the 2-year Summary Report
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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
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Prepregnancy counseling (2019)

The goal of prepregnancy care is to reduce the risk of adverse health effects for the woman, fetus, and neonate by working with the woman to optimize health, address modifiable risk factors, and provide education about healthy pregnancy. View the Committee Opinion
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ASRM Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic

It has become clear that the COVID-19 pandemic is not likely to be completely eradicated, but it will eventually transition to an endemic disease. View the document and updates

Topic Resources

View more on the topic of third-party reproduction
Coding Icon

Who to bill for gestational carrier services if intended parents have insurance?

I wanted to inquire about guidelines for billing services to a surrogate’s insurance company if intended parents purchased the insurance coverage.  View the Answer
Coding Icon

Mental health assessment for donors and intended parents

Is it appropriate to use 96156 or 96167 for mental health professional (MHP) counseling of gamete/embryo donors and gestational carriers? View the Answer
Document Icon

Family members as gamete donors or gestational carriers: an Ethics Committee opinion (2024)

The use of adult intrafamilial gamete donors and gestational surrogates is ethically acceptable when all participants are fully informed and counseled. View the Committee Document
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Diagnosis code for donation

What is the diagnosis code for an embryo donation versus egg donation? View the Answer
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Submitting female codes under a male patient in a donor cycle

We got a rejection from the clearinghouse for using a female diagnosis under a male patient.  View the Answer
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Billing donor services to IP’s insurance

When an intended parent has donor coverage under their insurance, how do we bill the donor services to their insurance? View the Answer
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