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? How do you identify the donor egg retrieval on the recipient’s claim?
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Coding Q&A
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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.
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?
Reimbursement for 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.
Billing egg donor’s retrieval to recipient’s insurance
How you would bill an egg donor’s retrieval to a patient’s insurance?Coding Corner
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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 egg donation
Fertility and Sterility On Air - Microdose Interview: Dr. Papri Sarkar and Dr. Phillip Romanski
Dr. Papri Sarkar and Dr. Phillip Romanski, discuss their recent article "Optimal antimüllerian hormone levels in oocyte donors: a national database analysis." Listen to the Episode
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
Reimbursement for 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
Misconduct in third-party assisted reproductive technology by participants and nonmedical professionals or entities: an Ethics Committee opinion (2023)
In some instances, it is ethically permissible for the physician to either disclose material information to the affected party or to decline to provide or continue to provide care. View the Committee Opinion
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
Billing egg donor’s retrieval to recipient’s insurance
How you would bill an egg donor’s retrieval to a patient’s insurance? View the Answer
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
IVF Case Rates
What ICD-10 codes apply to case rates? View the Answer
Donor Screening
Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code? 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
Diagnosis Code For Same-Sex Egg Donation
We have a same-sex male couple with insurance coverage for IVF. View the Answer
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. View the Answer
Donor Egg Lot Acquisition
What is the code for egg lot acquisition? View the Answer
Donor Eggs-Physical Exam
Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code? 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
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
Updated terminology for gamete and embryo donors: directed (identified) to replace ‘‘known’’ and nonidentified to replace ‘‘anonymous’’: a committee opinion (2022)
ASRM encourages all stakeholders with an interest in gamete and embryo donation to adopt directed (identified). View the Committee Opinion
Financial compensation of oocyte donors: an Ethics Committee opinion (2023)
Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds. View the Committee Opinion
Guidance regarding gamete and embryo donation (2021)
This document provides the latest recommendations for the evaluation of potential sperm, oocyte, and embryo donors as well as their recipients. View the Committee Opinion
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
Repetitive oocyte donation: a committee opinion (2020)
Donors should be advised of the number of cycles/donations that a given oocyte donor may undergo. View the Committee Opinion
Using family members as gamete donors or gestational carriers (2017)
The use of adult intrafamilial gamete donors and gestational surrogates is generally ethically acceptable when all participants are fully informed. View the Committee Document
Oocyte or embryo donation to women of advanced reproductive age: an Ethics Committee opinion (2016)
Advanced reproductive age (ARA) is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. View the Committee OpinionTopic 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
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? 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
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
Dec 2020: New Evaluation and Management Codes for 2021
Effective January 1, 2021, Evaluation and Management Codes will be changed for office visits only. View the LinkTopic Resources
View more on the topic of third-party reproduction
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
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
Reimbursement for 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
Misconduct in third-party assisted reproductive technology by participants and nonmedical professionals or entities: an Ethics Committee opinion (2023)
In some instances, it is ethically permissible for the physician to either disclose material information to the affected party or to decline to provide or continue to provide care. View the Committee Opinion
Defining embryo donation: an Ethics Committee opinion (2023)
The ethical appropriateness of patients donating embryos to other patients for family building, or for research, is well established.
View the Committee Opinion
Gestational Carrier
I would like to confirm ASRM’s opinion on the best code to use for a gestational carrier cycle. View the Answer
Donor Screening
Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code? 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
Diagnosis Code For Same-Sex Egg Donation
We have a same-sex male couple with insurance coverage for IVF. View the Answer
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. View the Answer
Donor Egg Lot Acquisition
What is the code for egg lot acquisition? View the Answer
Donor Eggs-Physical Exam
Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code? 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
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
