Registration is open for the 2024 ASRM Scientific Congress & Expo

Menu
Close Close Icon

HyCoSy and CPT 74740


When the following service (Office HSG/HyCoSy) is performed but no x-ray/fluoroscopic imaging is performed, and only an ultrasound is done, is it appropriate to bill CPT code 74740? A new physician to our practice noted the following:  The office HSG is a procedure otherwise known as HyCoSy.  Tubal patency is assessed via additional infusion of air bubbles through the fallopian tubes and confirming patency by ultrasound. It does not require x-ray equipment. 74740 captures the additional performance of tubal patency in addition to the codes otherwise used for SIS.

The definition of 74740 is Hysterosalpingography, radiological supervision, and interpretation. Is this code allowed to be billed if an X-ray is not actually performed and only an ultrasound is performed? Am I misinterpreting the definition of what this code defines? How would one properly code HyCoSy?

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
Coding ART Clinical Care teaser

Billing for E/M Visits

When billing Evaluation & Management (E/M) visits based on medical decision-making, would we
Coding ART Clinical Care teaser

When to use code Z31.83

When a patient is completing an approved fertility cycle, is it necessary
Coding ART Clinical Care teaser

Timed Intercourse Cycle Codes

Is it appropriate to utilize codes N97.8 or
Coding ART Clinical Care teaser

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:  

Coding Corner


Coding Corner is segmented into the following sections. Click an image below to view questions and answers in that section.


Coding_Andrology_Teaser.png
Coding_ARTClinicalCare_Teaser.png
Coding_ART_Lab_Teaser.png
Coding_Surgery_Teaser.png


Coding_ThirdParty_Teaser.png
Coding Summaries_Teaser.png
Coding_ChairLetters_Teaser.png
Coding Documents_Teaser.png

More Resources

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.

View the MAC Tool
EMR Phrases teaser
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.

View the library
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.

View ASRM Practice Documents
Ethics Committee teaser

ASRM Ethics Opinions

Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.

View ASRM Ethics Opinions
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.

View the Q & A
Covid-19 teaser
Practice Guidance

COVID-19 Resources

A compendium of ASRM resources concerning the Novel Corona virus (SARS-COV-2) and COVID-19.

View the resources
Couple looking at laptop for online patient education materials

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.

View Website

Topic Resources

View more on the topic of hysterosalpingogram (HSG)
Coding Icon

Coding for fluid aspiration during HSG

For physician-performed sonoHSG (58340& 76831) and uterine aspiration due to fluid, can an additional code for the aspiration be billed? View the Answer
Coding Icon

Q9967 for HSG

When is it appropriate to bill Q9967 for an HSG?  View the Answer
Coding Icon

SHG/HSG

If the answer is “if you perform the injection of contrast for an HSG at a radiology facility, you can report 58340: introduction of saline or contrast.”  View the Answer
Coding Icon

HSG Denied As Bundled Or Incidental

We are using and was recommended by the rep: 58340, 77002, Q9967, 74740, 99213-25 77002 commonly is being denied as bundled or incidental. View the Answer
Coding Icon

HSG Using Fertility Testing Code

With the new ICD 10 coding it appears that using a code of "fertility testing" rather than infertility is more likely to be covered for HSG procedures. View the Answer
Coding Icon

Hysterosalpingo Contrast Sonography

What is the appropriate code for HyCoSy? View the Answer
Document Icon

ASRM position statement on qualifications for providing ultrasound procedures in reproductive medicine (2022)

ASRM affirms that completion of fellowship training in reproductive endocrinology and infertility meets the criteria for requisite education. View the Position Statement

Topic Resources

View more on the topic of female fertility
Coding Icon

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 Answer
Coding Icon

Billing 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 Answer
Coding Icon

HyCoSy 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 Answer
Document Icon

Tobacco 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 Opinion
Coding Icon

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). View the Answer
Coding Icon

Total versus Free estradiol

Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? View the Answer
Coding Icon

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
Coding Icon

Sperm 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 Answer
Coding Icon

Post Vasectomy Infertility

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

Testing With No History of Infertility

What diagnosis codes should  providers submit to insurance carriers while trying to evaluate fertility issues? View the Answer
Coding Icon

Transvaginal Cyst Aspiration

If a cyst aspiration is completed in office, what codes could be used for this service in a clinic setting? View the Answer
Coding Icon

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
Coding Icon

Ovulation Induction Monitoring With PCOS

We have a patient insisting that we code the ultrasound follicle monitoring with the PCOS diagnosis.  View the Answer
Coding Icon

Diagnostic 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 Answer
Document Icon

Optimizing 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 Opinion
Document Icon

Use 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 Opinion
Document Icon

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
Document Icon

American 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 Opinion
Document Icon

Removal 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 Guideline
Document Icon

Uterus 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 discussion
Document Icon

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
Document Icon

Improving 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 Guideline
Document Icon

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

Topic Resources

View more on the topic of infertility
PR Bulletin Icon

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
Coding Icon

Billing for E/M Visits

When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the Answer
Coding Icon

When to use code Z31.83

When a patient is completing an approved fertility cycle, is it necessary View the Answer
Coding Icon

Timed Intercourse Cycle Codes

Is it appropriate to utilize codes N97.8 or View the Answer
Coding Icon

Appropriate Use of Modifier -25

Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the Answer
Document Icon

The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)

PGT-A use in the U.S. is rising, but its value as a routine IVF screening test is unclear, with mixed results from various studies. View the Committee Opinion
Videos Icon

Fertility Support and AI: Help or Hinderance

Discover how fertility apps impact patient care and nursing staff. Explore the balance between tech and human touch in complex fertility treatments View the ASRMed Talk Video
Advocacy Icon

National Infertility Awareness Week

April 20-26, 2025, is National Infertility Awareness Week (NIAW)! 

View the NIAW Toolkit
Podcast Icon

Fertility and Sterility On Air - Seminal Article: Ernest Ng and Zhi Chen

June issue Seminal Contribution: a randomized controlled trial studying the use of progestins for ovulation supression in predicted high responders.  Listen to the Episode
PR Bulletin Icon

ASRM announces support for HOPE with Fertility Services Act

The American Society for Reproductive Medicine is proud to endorse the HOPE with Fertility Services Act (HR 8821).

View the Press Release
Coding Icon

HyCoSy 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 Answer
Document Icon

Subclinical hypothyroidism in the infertile female population: a guideline (2024)

This guideline reviews the risks and benefits of treating subclinical hypothyroidism in female patients with a history of infertility and miscarriage. View the Committee Guideline
PR Bulletin Icon

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
News Icon

Infertility Awareness

In honor of National Infertility Awareness Week (NIAW), we have rounded up some of our resources on infertility. View infertility resources
News Icon

Leave Your Mark! NIAW April 21-27

National Infertility Awareness Week Action Round-Up Click here to leave your mark during NIAW2024
PR Bulletin Icon

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
Document Icon

Tobacco 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 Opinion
Videos Icon

Journal Club Global: The future of REI Fellowship training: debating opportunities and threats

This exciting collaboration discusses the controversy and future directions for the field of Reproductive Endocrinology and Infertility medicine. View the Video
Videos Icon

Journal Club Global: Infertility and Subclinical Hypothyroidism

The impact of treating SCH on fertility, obstetric outcomes, and offspring neurocognitive development is debated in the literature. View the Video
Document Icon

Ethical obligations in fertility treatment when intimate partners withhold information from each other: an Ethics Committee opinion (2024)

Clinicians should encourage disclosure between intimate partners but should maintain confidentiality where there is no harm to the partner and/or offspring. View the Committee Opinion
Document Icon

Ethical considerations for telemedical delivery of fertility care: an Ethics Committee opinion (2024)

Telemedicine has the potential to increase access to and decrease the cost of care. View the Committee Opinion
Document Icon

Definition of infertility: a committee opinion (2023)

‘‘Infertility’’ is a disease, condition, or status characterized by several factors. View the Committee Opinion
Document Icon

Diagnostic 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 Opinion
Videos Icon

Journal Club Global - Actualización en la suplementación con progesterona en fase lútea para transferencias de embriones congelados

Efectividad del rescate de progesterona en mujeres que presentan niveles bajos de progesterona circulante alrededor del día de la transferencia de embriones View the Video
Document Icon

Endometriosis and infertility: a committee opinion (2012)

Women with endometriosis typically present with pelvic pain, infertility, or an adnexal mass, and may require surgery. View the Committee Opinion
Document Icon

The International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)

Terms and definitions currently used infertility care, infertility and medically assisted reproduction (MAR) can have different meanings that are dependent upon the setting, their usage in research or clinical interventions, or among diverse populations.
View the Committee Joint Guideline
Coding Icon

Surgery Coding

I took the ASRM coding course, and in that course, coding for bilateral neosalpingostomies was coded using only a dx of N70.11 (hydrosalpinx). View the Answer
Coding Icon

Post Vasectomy Infertility

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

Pregnancy Of Uncertain Viability Ultrasound

My staff is telling me that I am getting reimbursed for the first sonogram and OB visit (using ICD 10 code for pregnancy of uncertain viability – O36.80X0. View the Answer
Coding Icon

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
Coding Icon

Self-referred New Patient

A patient self-refers to our physician for an initial new patient consultation instead of referred by another physician, how do we code for the consult? View the Answer
Coding Icon

Telephone Consult

Does a physician need to speak directly to a patient to code for a telephone consult (99371-99373) or can a staff member relay physician notes to patients? View the Answer
Coding Icon

Testing With No History of Infertility

What diagnosis codes should  providers submit to insurance carriers while trying to evaluate fertility issues? View the Answer
Coding Icon

Psychological Evaluation

Many REs require patients (and their spouses/partners) who are considering using donor gametes to see an infertility counselor first. View the Answer
Coding Icon

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
Coding Icon

Infertility Consult

Does ASRM have any examples of evaluation and management documentation for patients being seen for an initial infertility evaluation? View the Answer
Coding Icon

Infertility Consult by Nurse

What code is used for a nurse practitioner seeing a fertility patient for the first time? View the Answer
Coding Icon

Initial Visit for Infertility With No Mandated Coverage

What code would be appropriate for an initial visit for infertility?  View the Answer
Coding Icon

New vs Established Patient

How soon can you bill as a new infertility patient? View the Answer
Coding Icon

Hysteroscopy Recurrent Implantation Failure

What is the appropriate ICD-10 code for recurrent implantation failure?  View the Answer
Coding Icon

General E&M Consult

Recently we have received a “re-code” on a new patient (we billed a 99203 and the insurance re-coded it to a 99213).  View the Answer
Coding Icon

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
Coding Icon

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
Coding Icon

Diagnostic 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 Answer
Coding Icon

Blood Draws

If a patient comes in only for a blood draw (venipuncture) and is seen only by the lab technician (not an MD, PA, or NP), may we bill for a (minimal) office visit? View the Answer
Coding Icon

Blood Tests

Patients are requesting to have lab work drawn from the female patient moved to the males account due to the female fertility coverage being maxed out.  View the Answer
Coding Icon

Male Infertility

A summary of common codes for Male Infertility compiled by the ASRM Coding Committee. View the Coding Summary
Document Icon

ASRM müllerian anomalies classification 2021

The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability. View the Committee Opinion
Document Icon

Intracytoplasmic 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 Document
Document Icon

Moving innovation to practice: an Ethics Committee opinion (2021)

The introduction of new strategies, tests, and procedures into clinical practice raises challenging ethical issues. View the Committee Opinion
Document Icon

Fertility evaluation of infertile women: a committee opinion (2021)

Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner. View the Committee Opinion
Document Icon

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
Document Icon

Use 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 Opinion
Document Icon

Reproductive and hormonal considerations in women at increased risk for hereditary gynecologic cancers: Society of Gynecologic Oncology and American Society for Reproductive Medicine Evidence-Based Review (2019)

Providers who care for women at risk for hereditary gynecologic cancers must consider the impact of these conditions. View the Joint Statement
Document Icon

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
Document Icon

American 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 Opinion
Document Icon

Child-rearing ability and the provision of fertility services: an Ethics Committee opinion (2017)

Fertility programs may withhold services on the basis that patients will be unable to provide minimally adequate or safe care for offspring. View the Committee Opinion
Document Icon

Removal 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 Guideline
Document Icon

Improving 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 Guideline