Billing both partners for 99205 initial consultation
- Is it still compliant to submit for the consultation code on both partners if they both present for the consultation?
- How does this apply to same-sex couples? If a female same-sex couple presents and both females desire to have evaluation for consideration in treatment, can/should 99205 be submitted to both partners' insurance?
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Coding Q&A
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Topic Resources
Documentation for ultrasound coding 76830
Regarding billing code 76830: it “includes imaging of the uterus, endometrium, fallopian tubes, ovaries, and pelvic structures such as the bladder, as indicated. View the AnswerBilling both partners for 99205 initial consultation
We discussed the ability to bill 99205 for an initial consultation on both the male and female partners if they both present for the consultation. View the AnswerHyCoSy and CPT 74740
When Office HSG/HyCoSy is performed but no x-ray/fluoroscopic imaging is performed, only ultrasound is done, is it appropriate to bill CPT code 74740? View the AnswerTobacco or marijuana use and infertility: a committee opinion (2023)
In the United States, approximately 21% of adults report some form of tobacco use, although 18% report marijuana use. View Committee OpinionExclusion of IVF services due to Z31.83
My wife and I have been seeking IVF treatment and this year coverage was added to my benefits for infertility treatment (up to $25,000). View the AnswerTotal versus Free estradiol
Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? View the AnswerVitamin 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 AnswerTesting With No History of Infertility
What diagnosis codes should providers submit to insurance carriers while trying to evaluate fertility issues? View the AnswerTransvaginal Cyst Aspiration
If a cyst aspiration is completed in office, what codes could be used for this service in a clinic setting? View the AnswerSperm Wash No Male Factor
What would be the best code to use for a sperm wash when it is not a male factor issue? View the AnswerPost Vasectomy Infertility
If a husband has had a vasectomy, does the sterilization code apply to the wife's visits? View the AnswerIUI or IVF
Should other ovarian dysfunction (diagnosis code E28.8) or unspecified ovarian dysfunction (diagnosis code E28.9) can be used for an IUI or an IVF cycle View the AnswerOvulation Induction Monitoring With PCOS
We have a patient insisting that we code the ultrasound follicle monitoring with the PCOS diagnosis. View the AnswerDiagnostic Testing of an Infertile Couple
The Z31.41 is or is not the correct code to use for diagnostic testing of an infertile couple? And If so can if be used as the primary and only code? View the AnswerOptimizing natural fertility: a committee opinion (2022)
This committee opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples... View the Committee OpinionUse of exogenous gonadotropins for ovulation induction in anovulatory women: a committee opinion (2020)
Pretreatment evaluation, indications, treatment regimens, and complications of gonadotropin treatment. View the Committee OpinionGuidance 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 GuidelineAmerican Society for Reproductive Medicine position statement on uterus transplantation: a committee opinion (2018)
Following the birth of the first child from a transplanted uterus in Gothenburg, Sweden, in 2014, other centers worldwide have produced scientific reports. View the Committee OpinionRemoval of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline (2017)
This review evaluates if uterine myomas impact likelihood of pregnancy and pregnancy loss, and if myomectomy influences pregnancy outcomes. View the GuidelineUterus Transplantation Intersociety Roundtable (2016)
A Roundtable to discuss the development of uterus transplantation in the United States was convened under the sponsorship of ASRM and ASRT. View Roundtable discussionImproving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement (2014)
Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public. View the GuidelineRecommended 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 RecommendationBest practices of ASRM and ESHRE: a journey through reproductive medicine (2012)
ASRM and ESHRE are the two largest societies in the world whose members comprise the major experts and professionals working in reproductive medicine. View the Committee Joint GuidelineTopic Resources
AUA Releases Male Infertility Guideline Amendment
The AUA, in collaboration with the American Society for Reproductive Medicine (ASRM), has released the 2024 amendment to the Male Infertility Guideline.
View the Press ReleaseBilling for the partner workup
Are most practices in REI billing male partners for their history? We also order labs and sperm count on all male partners. View the AnswerBilling both partners for 99205 initial consultation
We discussed the ability to bill 99205 for an initial consultation on both the male and female partners if they both present for the consultation. View the AnswerSemen analysis and thaw code
Can we use the semen analysis presence and motility (89300) code along with a reproductive tissue thaw code (89354) View the AnswerTESE test thaws
We perform test thaws to determine if frozen TESE specimens from other clinics are suitable for our procedures. View the AnswerTobacco or marijuana use and infertility: a committee opinion (2023)
In the United States, approximately 21% of adults report some form of tobacco use, although 18% report marijuana use. View Committee OpinionDiagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion (2023)
It is the responsibility of the clinician to assess for erectile dysfunction, ejaculatory dysfunction, or diminished libido in men presenting for infertility. View the Committee OpinionTesting With No History of Infertility
What diagnosis codes should providers submit to insurance carriers while trying to evaluate fertility issues? View the AnswerSemen Analysis For Assessment of Fertility
What is the appropriate diagnostic code to use for a semen analysis for the assessment of infertility? View the AnswerPost Vasectomy Infertility
If a husband has had a vasectomy, does the sterilization code apply to the wife's visits? View the AnswerLab RVUs
Is there a list of RVUs for embryology and andrology laboratory procedures, and if so, where can it be found? View the AnswerMale Consult
My group was wondering if and how to code for a male partner consultation. View the AnswerDiagnostic Testing of an Infertile Couple
The Z31.41 is or is not the correct code to use for diagnostic testing of an infertile couple? And If so can if be used as the primary and only code? View the AnswerJournal Club Global Live from PCRS - ICSI for Non-Male Factor Infertility
While intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of male factor infertility, a significant controversy still remains regarding its ubiquitous use in all IVF cycles. View the VideoOptimizing natural fertility: a committee opinion (2022)
This committee opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples... View the Committee OpinionIntracytoplasmic sperm injection (ICSI) for non–male factor indications: a committee opinion (2020)
Intracytoplasmic sperm injection is frequently used in combination with assisted reproductive technologies. View the Committee DocumentDiagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2021)
Part I outlines the appropriate evaluation of the male in an infertile couple. View the GuidelineDiagnosis and Treatment of Infertility in Men: AUA/ ASRM Guideline Part II (2021)
The summary presented is Part II of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. View the GuidelineGuidance 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 GuidelineImproving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement (2014)
Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public. View the GuidelineRecommended 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 RecommendationTopic Resources
Fertility Care Gets Important Win in California
ASRM celebrates California's SB 729, expanding IVF coverage for same-sex couples and singles, advancing equitable fertility care access.
View the Press Release