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 like we would for a global plan? For example, if one provider saw the patient initially, set the plan, and ordered the cycle charges. Would we bill this whole cycle under that provider, or bill each line under the specific provider that performed the procedure (ex. the retrieval)? Usually with other specialties, we would bill under the performing provider, is there an exemption for IVF? Is this like global cases that are billed for OB services?
Login now to view this Coding information. Coding Resources are available to ASRM Members only.
If you are not an ASRM member and would like to be, visit the Membership Tab above.
Coding Q&A
View more Coding Q&A in this category
Guidance for coding limited or follow-up ultrasounds used during an IVF Cycle
I am a coder for a Reproductive Endocrinologist's office and am looking for some guidelines on limited or follow-up ultrasounds used during an IVF Cycle.
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.
Measurements to report with ultrasound codes
Are there clear guidelines as to what measurements are required in order to bill for each type of ultrasound?
Exclusion 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).Coding Corner
Coding Corner is segmented into the following sections. Click an image below to view questions and answers in that section.
More Resources
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
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 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 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
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
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 in vitro fertilization (IVF)
ASRM Reacts to Cruz/Britt OPED
We are pleased to see Senators Cruz and Britt express their interest in protecting access to IVF.
View the Press Release
Fertility and Sterility On Air - Unplugged: April 2024
Topics include: IVF in film, a rat model of fallopian tube torsion, comparing letrozole regimens for PCOS, and a review of chronic endometritis. Listen to the Episode
ASRM Files Amicus Brief in Texas Embryo Case
ASRM has filed an amicus curiae (friend of the court) brief in the case of Antoun v Antoun, which is pending before the Texas Supreme Court.
View the Press Release
Survey shows strong support for increased access to fertility treatments
A new public opinion poll reveals strong support for improved access to In Vitro Fertilization (IVF).
View the Press Release
National Infertility Awareness Week 2024: Leave Your Mark
Next week is National Infertility Awareness Week, a federally recognized health observance founded to increase awareness of infertility.
View the Press Release
ASRM Today: ASRM Policy Matters: Post-Alabama IVF decision advocacy roundup with Jessie Losch
Jessie Losch, ASRM Government Affairs Manager, updates ASRM Today on the advocacy efforts underway post the Alabama Supreme Court decision. Listen to the Episode
IVF-assisted pregnancies constitute 2.5% of all births in 2022
In 2022, the number of babies born from IVF increased from 89,208 in 2021 to 91,771 in 2022. This means that 2.5% of births in the US are a result of ART.
View the Press Release
Fertility and Sterility On Air - Live from PCRS 2024
Fertility & Sterility on Air brings you the highlights from the 2024 Annual Meeting of the Pacific Coast Reproductive Society. Listen to the Episode
Fertility and Sterility On Air - Seminal Article: Dr. Jeremy Applebaum
Listen to this interview featuring Dr. Jeremy Applebaum, who recently published "Impact of coronavirus disease 2019 vaccination on live birth rates after IVF" Listen to the Episode
ASRM provides testimony to Senate Judiciary Committee on threats facing IVF
ASRM shared with the Senate Judiciary Committee the dangers to reproductive medicine nearly two years after the Dobbs decision.
View the Press Release
Fertility and Sterility On Air - TOC: March 2024
Topics this month include the impact of COVID-19 vaccination on live birth rates after IVF, the "freeze-all" strategy in women with adenomyosis, and more. Listen to the Episode
ASRM reacts to Alabama legislation
We are pleased that the legislation passed into law by the Alabama General Assembly will at least allow our members in the state to care for their patients.
View the Press Release
IVF at the SOTU: Fertility care expected to be major focus at State of the Union
Protecting access to IVF care is expected to be a major theme of the State of the Union on Thursday.
View the Press Release
ASRM Responds to Proposed Alabama Legislation
We are proud of our Alabama members and their patients, who have been such incredible advocates working to motivate their legislators to protect IVF.
View the Press Release
Senate Budget Hearing is Well Timed Following Alabama IVF Ruling
ASRM statement regarding the Senate Budget Committee’s hearing entitled: No Rights to Speak of: The Economic Harms of Restricting Reproductive Freedom.
View the Press Release
ASRM Responds to Senate’s Failure to Pass Access to Family Building Act
We are disappointed by the Senate’s failure to meet the moment and pass federal legislation protecting access to in vitro fertilization (IVF).
View the Press Release
Alabama Supreme Court Rules Frozen Embryos are “Unborn Children” and admonishes IVF’s “Wild West” treatment
Legally Speaking™ on presenting facts and reflecting on the impact and potential implications of legal developments in ART. View the Column
ASRM Condemns Profoundly Misguided and Dangerous Court Decision in Alabama
In LePage v Mobile Infirmary Clinic, the Alabama Supreme Court made a decision that flies in the face of medical reality and the needs of the citizens.
View the Press Release
Fertility and Sterility On Air - TOC: February 2024
Topics this month include the optimial AMH level in oocyte donors, the role of mean number of DNA breakpoints (MDB) in sperm DNA integrity, and more. Listen to the Episode
Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline (2023)
Ovarian hyperstimulation syndrome is a serious complication associatedwith assisted reproductive technology. View the guideline
Fertility and Sterility On Air - Unplugged: January 2024
Topics this month include: HCG as a predictor of pregnancy outcome after IVF, progestin ovulation suppression and embryo development, and more. Listen to the Episode
ASRM applauds introduction of Access to Family Building Act of 2024
ASRM is thrilled by the introduction of the Access to Family Building Act
View the Press Release
Billing IVF lab work
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
Journal Club Global: IVM in Clinical Practice: An Idea Whose Time Has Come?
In vitro maturation (IVM) has the potential to make IVF cheaper, safer, and more widely accessible to patients with infertility. View the Video
Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF: a guideline (2018)
Mild-stimulation protocols with in vitro fertilization (IVF) generally aim to use less medication than conventional IVF. View the Guideline
IVF cycle management and facility fees, an overview
How should IVF Cycle Management be coded? View the Answer
Limited ultrasound performed by RN
Would it be appropriate to bill a 99211 when an RN is doing a limited ultrasound and documenting findings during an IUI or IVF treatment cycle? View the Answer
CPT 89253 and 89254 for Assisted hatching
Can I bill CPT codes 89253 and 89254 together? If yes, do I need a modifier on any of the codes? View the Answer
Journal Club Global - What is the optimal number of oocytes to reach a live-birth following IVF?
The optimal number of oocytes necessary to expect a live birth following in vitro fertilization remains unclear. View the Video
Patient Education
What is the correct way to bill for the patient education sessions performed by registered nurses to individual patients prior to their IVF cycle? View the Answer
Pregnancy Ultrasound
Our practice does routine ultrasounds (sac check- 76817) at the end of an IVF cycle and bill with a diagnosis code O09.081, pregnancy resulting from ART. View the Answer
IUI 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 Answer
IVF Case Rates
What ICD-10 codes apply to case rates? View the Answer
IVF Consent Counseling
When a patient is scheduled to undergo IVF and the provider schedules the patient for a 30-minute consultation is this visit billable? View the Answer
Ovulation Induction Monitoring for IUI
We would like to clarify the correct ICD 10 diagnosis code for monitoring of an IUI cycle. View the Answer
In Vitro Maturation
Have CPT codes been established for maturation in vitro? View the Answer
IVF Billing Forms
I am seeking information on IVF insurance billing guidelines. View the Answer
IVF Billing Globally
Am I correct in assuming that it is duplicate billing for both the ambulatory center and embryology laboratory to bill globally? View the Answer
IVF Billing of Professional Charges
Are we allowed to bill professional charges under the physician for the embryologist who performs the IVF laboratory services? View the Answer
Lab Case Rates
What ICD-10 codes apply to case rates? View the Answer
Oocyte Denudation
Is there is a separate code for denudation of oocytes? View the Answer
IV Fluids During Egg Retrieval
Is it appropriate to bill the insurance company for CPT 96360, Under Hydration Infusion when being used in conjunction with IVF retrieval? View the Answer
Endometrial Biopsy/Scratch
What CPT code should be used for a “scratch test”? View the Answer
Endometriosis and Infertility
For treatment like IVF would we bill with N97.x first or an endometriosis diagnosis? View the Answer
Follicle Monitoring For Diminished Ovarian Reserve
If a patient has decreased ovarian reserve (ICD-10 E28.8) and patient is undergoing follicle tracking to undergo either an IUI cycle or IVF cycle... View the Answer
Diagnosis of Infertility for IVF Procedure
How important is it to have accurate documentation of the type of infertility diagnosis for IVF procedures? View the Answer
Egg Culture and Fertilization
We are billing for the technical component of 89250 and would like to also bill a professional component of the 89250. View the Answer
Egg Culture and Fertilization: Same Gender
A same-sex male couple requested half their donor eggs be fertilized with sperm from male #1 and the other half fertilized from male #2. View the Answer
Donor Embryos
Could you give guidance for the correct ICD-10 code(s) to use when a patient is doing an Anonymous Donor Embryo Transfer cycle? View the Answer
Journal Club Global: Natural versus Programmed FET Cycles
A significant portion of IVF cycles now utilize frozen embryo transfer.
View the Video
Role of assisted hatching in in vitro fertilization: a guideline (2022)
There is moderate evidence that assisted hatching does not significantly improve live birth rates in fresh assisted reproductive technology cycles View the Committee Opinion
Journal Club Global - Best Practices of High Performing ART Clinics
This Fertility and Sterility Journal Club Global discusses February’s seminal article, “Common practices among consistently high-performing in vitro fertilization programs in the United States: a 10 year update.” View the Video
Guidance on the limits to the number of embryos to transfer: a committee opinion (2021)
ASRM's guidelines for the limits on the number of embryos to be transferred during IVF cycles have been further refined ... View the Committee Opinion
Journal Club Global Live from India - Adjuvants in IVF and IVF Add-Ons for the Endometrium
Many adjuvants have been utilized by IVF centers to improve their success rates. View the Video
Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline (2021)
A review of success rates, factors that may impact success rates, and outcomes. View the Committee Opinion
Development of an emergency plan for in vitro fertilization programs: a committee opinion (2021)
All IVF programs and clinics should have a plan to protect fresh and cryopreserved human specimens (embryos, oocytes, sperm). View the Committee Opinion
In vitro maturation: a committee opinion (2021)
The results of in vitro maturation (IVM) investigations suggest the potential for wider clinical application. View the Committee Opinion
Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion (2019)
The Ethics Committee recommends that in vitro fertilization (IVF) centers develop patient-centered policies regarding requests for futile treatment. View the Committee Opinion
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
The role of immunotherapy in in vitro fertilization: a guideline (2018)
Adjuvant immunotherapy treatments in in vitro fertilization (IVF) aim to improve the outcome of assisted reproductive technology (ART) in both the general ART population as well as subgroups such as patients with recurrent miscarriage or implantation failure. View the Committee Opinion
Performing the embryo transfer: a guideline (2017)
A systematic review of the literature was conducted which examined each of the major steps of embryo transfer. Recommendations made for improving pregnancy rates are based on interventions demonstrated to be either beneficial or not beneficial. (Fertil Steril® 2017;107:882–96. ©2017 by American Society for Reproductive Medicine.) View the Committee Guideline
Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2016)
Financial ‘‘risk-sharing’’ fee structures in assisted reproduction programs charge patients a higher initial fee but provide reduced fees for subsequent cycles and often a partial or complete refund if treatment fails. View the Committee Document
Best 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 Guideline
In Vitro Maturation Special Interest Group (IVMSIG)
IVMSIG strives to define the best strategies to optimize IVM outcomes. Learn more about IVMSIG
What support for IVF looks like
Bipartisan support for IVF, that is responsible for the birth of over 2% of all babies born in the USA each year, will ensure that families continue to grow. View the advocacy resource
It takes more than one
Why IVF patients often need multiple embryos to have a baby View the advocacy resource
Advocacy Resources
ASRM has prepared resources to help explain and advocate for reproductive rights and the continuation of in vitro fertilization and other fertility treatments. View the advocacy resourcesTopic Resources
View more on the topic of insurance
Survey shows strong support for increased access to fertility treatments
A new public opinion poll reveals strong support for improved access to In Vitro Fertilization (IVF).
View the Press Release
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
Total versus Free estradiol
Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? View the Answer
Endometrioma
Surgery was performed under anesthesia for Aspiration of right hyrosalpinx fluid and right endometrioma. 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
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
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
Flat Fee For Outside Monitoring
Can our office charge outside monitoring patients a flat fee to be seen? View the Answer
Embryo Culture Denied As Experimental
We have received denials from insurance payers when billing CPT code 89251. View the Answer
Frozen Embryo Transport
What is the code for the cost of frozen embryo transport? 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
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 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
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
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
Billing For Cryopreservation Of Embryos Under The Male Partner
Can 89258 be billed under the male partner of a female patient? View the Answer
Coding For Long-Term Storage Of Embryos
We have recently been contacted by a payer stating we have a patient whose plan will cover long-term storage of her embryos. View the Answer
Claim Form for Donor Egg Retrieval
What bill form is used of IVF donor egg retrieval? 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
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
