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Assisted Hatching Billed With Embryo Biopsy

Do you know if both assisted hatching (89253) and embryo biopsy for PGS/PGD/CCS (89290/89291) can be billed during the same cycle? For example, AH on day three, embryo biopsy on day 5/6 during blast stage. Or, does the embryo biopsy essentially take the place of AH when performed?

Assisted Zona Hatching

Can assisted hatching and embryo biopsy for PGT-A; PGT-M or PGT-SR be billed during the same cycle? 

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. Is there a diagnosis code that works best for billing 89342 or should it be billed with the diagnosis code indicated on the IVF cycle that created the embryos?

Coding For Ovarian Tissue Cryopreservation

Now that ASRM has removed the "experimental" designation from ovarian tissue cryopreservation for postpubertal girls and women, what CPT code should be used instead of 0058T?

Denudation of Oocytes

Is there is a separate code for denudation of oocytes? And if denuding oocytes is bundled into another code for either IVF or ICSI, please explain.

Egg Culture and Fertilization

We have a hospital-based embryology lab that is headed by a physician. We are billing for the technical component of 89250 and would like to also bill a professional component of the 89250. We have not been able to support the professional billing of this code (89250). After extensive research, we cannot find anything definitive. It seems to me that there is sufficient physician involvement to generate a professional fee. This code does appear on at least one of our contracted payment schedules, but does not appear on the Medicare physician fee schedule.

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 of donor eggs be fertilized with sperm from male #2.  How should this be billed? Specifically, in our split donor egg cycle for this same-sex male couple, we performed two separate sperm preps, two fertilization procedures (in this case, one was fertilized by ICSI and the other by IVF).  We kept the two sets of embryos in separate dishes to culture and monitor extended culture of their embryos under separate case IDs, then we froze each embryo individually and stored each set of embryos created from each of the partners in separate canes. 

Embryo Biopsy

Have any new codes been introduced for the lab portion of PGT?

Embryo Biopsy Embryologist Travel Costs

Our clinic is just starting to do PGD.  We currently fly in an embryologist to perform the biopsy procedure.  Can we bill insurance for the biopsy procedure?  Can we bill for travel expenses?

Embryo Co-culture

Can codes 89250 and 89251 be billed on different days of the same cycle? We understand that both codes cannot be billed on the same day of service. However, is it compliant to bill 89250 in addition to 89251 on separate days of service?

Embryo Culture Denied As Experimental

We have received denials from insurance payers when billing CPT code 89251.  The denial indicates “experimental in nature, not FDA approved.”  I understand that CPT codes are not approved by FDA, but by the AMA.  Can you advise with appealing this denial?

Embryo Culture Less Than And More Than Four Days

When coding 89250 culture of oocytes/embryo <4 days, should that code be submitted to the insurance company for each of the days or is it only submitted one time over the multiple days of culture? Same question for 89272.

Embryo Freezing/Thawing

Our question refers to the CPT code 89258 “Cryopreservation; Embryo(s)” and 89352 “Thawing of Cryopreserved; Embryo”. Our question is when we cryopreserve embryos for a patient on multiple devices (CryoLock, CryoTip, CryoLef, etc. whichever device the laboratory is using), is it appropriate to charge the patient per device using this code? We are using more than one device and also using media with the suggested protocol per device, so we would ideally like to charge for the cryopreservation of embryos per device.      This question then also leads into thawing. If a patient requests to have two devices thawed for an FET (frozen embryo transfer) how can we charge per device when thawing embryos?

Embryo Thawing/Warming

Is it allowable to bill 89250 for the culture of embryos after thaw for a frozen embryo transfer (FET) cycle? Is there a certain time that the embryos must be in culture? The CPT code says <4 days.

Gamete Thawing/Warming

Can patients be charged for each vial/straw of reproductive gametes or tissues thawed? 

ICSI and Embryo Biopsy

How to bill for ICSI or embryo biopsies that occur in different days? So if 8 eggs were ICSI fertilized on one day but then the next day 4 more were ICSI’d would we then bill the 89281 code for the second day?  Same with PGTA?

IVF Billing Forms

I am seeking information on IVF insurance billing guidelines. When billing the lab procedures do you use a 1500 claim form only or in combination with the UB92? I am referring to: 58970, 58974, 89280, 89281, 89255, 89352, 89258, and 89253.

IVF Billing Globally

I am the Practice Manger of a fertility group.  We have a clinic and an ambulatory surgery center.  When billing a retrieval, we bill out a 58970 and 76948-26 under the physician, we bill the 89261, 89254, 89250, 89280 89272 and 89253, 89258 from our Embryology Lab with the same tax id.  Our surgery center additionally bills out the facility charges, billing out 58970 and 76948-TC and is billing out the 80000 codes as well.  It appears to me that the 80000 codes should either be billed by the lab with modifier -26 and the surgery center with modifier –TC or billed globally by the embryology lab.  I am correct in assuming that it is duplicate billing for both the ambulatory center and embryology laboratory to bill globally?

IVF Billing of Professional Charges

Are we allowed to bill professional charges under the physician for the embryologist who performs the IVF laboratory services (ICSI, hatching, cultures)?

Lab RVUs

Is there a list of RVUs for embryology and andrology laboratory procedures, and if so, where can it be found?

Oocyte Denudation

  1. Is there is a separate code for denudation of oocytes? and
  2. If denuding oocytes is bundled into another code for either IVF or ICSI, please explain.

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