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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. Code for the following:
  • A single female using donor IUI, or a lesbian couple using donor IUI
  • A transgender female coming to bank sperm before transitioning
  • A young professional women coming to bank eggs for social reasons

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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).

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Planned oocyte cryopreservation to preserve future reproductive potential: an Ethics Committee opinion (2023)

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Elective fertility preservation is ART

From an insurance standpoint, is fertility preservation is considered an assisted reproductive technology or would it be branched under other?  View the Answer
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Our center performs oocyte preservation procedures for women looking to preserve their fertility. View the Answer
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What code are we supposed to use for counseling regarding fertility preservation for an individual with cancer... View the Answer
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If the patient is undergoing ultrasound tracking visits for fertility preservation, what I ICD-10 code do you use for the monitoring? View the Answer
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Coding For Ovarian Tissue Cryopreservation

Now that ASRM has removed the "experimental" designation from ovarian tissue cryopreservation what CPT code should be used instead of 0058T? View the Answer
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IVF-assisted pregnancies constitute 2.5% of all births in 2022

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Coding Icon

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.  View the Answer
Coding Icon

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? VIew the Answer
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Coding Icon

IVF coverage denied for Z31.83 diagnosis code

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Document Icon

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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
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One of our clients received information that a repeat limited transvaginal ultrasound should be billed with a limited pelvic ultrasound code (76857). View the Answer
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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
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A summary of codes for Mental-health Services During Assisted Reproduction compiled by the ASRM Coding Committee View the Coding Summary
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Using family members as gamete donors or gestational carriers (2017)

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Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2016)

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View more on the topic of fertility preservation
Document Icon

Planned oocyte cryopreservation to preserve future reproductive potential: an Ethics Committee opinion (2023)

Planned oocyte cryopreservation is an ethically permissible procedure that may help individuals avoid future infertility. View the Committee Opinion
Coding Icon

Elective fertility preservation is ART

From an insurance standpoint, is fertility preservation is considered an assisted reproductive technology or would it be branched under other?  View the Answer
Coding Icon

Oocyte Preservation Consult

Our center performs oocyte preservation procedures for women looking to preserve their fertility. View the Answer
Coding Icon

Fertility Preservation Consult

What code are we supposed to use for counseling regarding fertility preservation for an individual with cancer... View the Answer
Coding Icon

Cycle Monitoring Fertility Preservation

If the patient is undergoing ultrasound tracking visits for fertility preservation, what I ICD-10 code do you use for the monitoring? View the Answer
Coding Icon

Coding For Ovarian Tissue Cryopreservation

Now that ASRM has removed the "experimental" designation from ovarian tissue cryopreservation what CPT code should be used instead of 0058T? View the Answer
Coding Icon

Fertility Preservation

A summary of codes for Fertility Preservation compiled by the ASRM Coding Committee. View the Coding Summary
Document Icon

Access to fertility services by transgender and nonbinary persons: an Ethics Committee opinion (2021)

The provision of fertility services to transgender individuals and the denial of access to fertility services is not justified. 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

Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion (2019)

Patients preparing to undergo gonadotoxic medical therapy, radiation therapy, or gonadectomy should be provided with prompt counseling regarding available options for fertility preservation for iatrogenic infertility. View the Committee Opinion
Document Icon

Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion (2018)

Chemotherapy and radiation therapy often result in reduced fertility. View the Committee Opinion
Membership Icon

Fertility Preservation Special Interest Group (FPSIG)

The FPSIG promotes knowledge on infertility induced by cancer therapy and other medical treatments. Learn more about FPSIG

Topic Resources

View more on the topic of insurance
Coding Icon

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
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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
Coding Icon

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
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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
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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
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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
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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
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Total versus Free estradiol

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

Surgery was performed under anesthesia for Aspiration of right hyrosalpinx fluid and right endometrioma. View the Answer
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Unlisted Fertility Treatment CPT Code

Can you please refer me to an unlisted management CPT code for fertility treatment? View the Answer
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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
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In-office HSG to visualize contrast dye

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Initial Visit for Infertility With No Mandated Coverage

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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
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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
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Flat Fee For Outside Monitoring

Can our office charge outside monitoring patients a flat fee to be seen?  View the Answer
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Global Billing Vs Billing Under Provider

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Embryo Culture Denied As Experimental

We have received denials from insurance payers when billing CPT code 89251.  View the Answer
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Frozen Embryo Transport

What is the code for the cost of frozen embryo transport? View the Answer
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Diagnosis Codes For Intrauterine Insemination (IUI)

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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
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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
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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
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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
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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
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Billing For Cryopreservation Of Embryos Under The Male Partner

Can 89258 be billed under the male partner of a female patient? View the Answer
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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
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Claim Form for Donor Egg Retrieval

What bill form is used of IVF donor egg retrieval? View the Answer
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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
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Male Infertility

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

A summary of codes for PCOS as compiled by the ASRM Coding Committee View the Coding Summary
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Recurrent Pregnancy Loss (RPL)

Strategy for coding for a patient with RPL - codes compiled by the ASRM Coding Committee.  View the Coding Summary
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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
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Embryo Transfer

A summary of Embryo Transfer codes collected by the ASRM Coding Committee View the Coding Summary
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Endometriosis

A summary of common codes for Endometriosis compiled by the ASRM Coding Committee View the Coding Summary
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Fibroids

A summary of codes to use with fibroids and myomas compiled by the ASRM Coding Committee View the Coding Summary
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Fertility Preservation

A summary of codes for Fertility Preservation compiled by the ASRM Coding Committee. View the Coding Summary
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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
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Jan 2021: Telehealth Coding Extension and 2021 Medicare Physician Fee Schedule

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Dec 2020: New Evaluation and Management Codes for 2021

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