Flat Fee For Outside Monitoring
Can our office charge outside monitoring patients a flat fee to be seen? The patients are under the care of another physician, but we are performing an ultrasound and bloodwork. Do we have to bill the insurance if they are coming to our office even though they are not being treated by our doctors?
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Coding Q&A
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Billing for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would we
When to use code Z31.83
When a patient is completing an approved fertility cycle, is it necessary
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.
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 assisted reproductive technologies
Use of preimplantation genetic testing for monogenic adult-onset conditions: an Ethics Committee opinion (2024)
Preimplantation genetic testing for monogenic diseases for adult-onset conditions is ethically permissible for various conditions, including when the condition is fully penetrant or confers disease predisposition. View the Committee Opinion
When to use code Z31.83
When a patient is completing an approved fertility cycle, is it necessary View the Answer
Timed Intercourse Cycle Codes
Is it appropriate to utilize codes N97.8 or View the Answer
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: View the Answer
Journal Club Global: Falha de implantação: realidade ou ilusão estatística?
Fertility and Sterility Global Journal Club from Brazil View the Video
Fertility and Sterility On Air - TOC: July 2024
Articles this month include: predicting ART complications, laser assisted hatching on vitrified blastocysts, predictive models of miscarriage and more.Listen to the Episode
The use of hormonal contraceptives in fertility treatments: a committee opinion (2024)
Hormonal contraception aids in the timing of ART cycles, reduce ovarian cysts at IVF cycle initiation, and optimize visualization before hysteroscopy. View the Committee Opinion
Family members as gamete donors or gestational carriers: an Ethics Committee opinion (2024)
The use of adult intrafamilial gamete donors and gestational surrogates is ethically acceptable when all participants are fully informed and counseled. View the Committee Document
Semen analysis and thaw code
Can we use the semen analysis presence and motility (89300) code along with a reproductive tissue thaw code (89354) View the Answer
Billing for assisted hatching at biopsy and transfer
We would also like to know if you can bill assisted hatching with biopsy and then assisted hatching again during the transfer cycle. View the Answer
Diagnosis code for donation
What is the diagnosis code for an embryo donation versus egg donation? View the Answer
Coding for an endometrial biopsy/Mock cycle
We had patients request us to bill their insurance for the two monitoring visits and the Endo BX and change the diagnosis code to something that is payable. View the Answer
Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2023)
Financial ‘‘risk-sharing’’ fee structures in programs charge patients a higher initial fee but provide reduced fees for subsequent cycles. View the Committee Document
Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline (2023)
Ovarian hyperstimulation syndrome is a serious complication associated with assisted reproductive technology. View the guideline
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
Billing for cryopreservation procedures on different days
I understand that if cryopreservation of oocytes is performed on two separate dates of service, each date of service was billable. View the Answer
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
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
Estradiol Free versus Total
Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? 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
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
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
Journal Club Global - Revisiting the STAR trial: The Fellows debate PGT-A
We are excited to host a debate covering the pros and cons of PGT-A and how new technologies should be validated before clinical implementation. View the Video
Informed consent in assisted reproduction: an Ethics Committee opinion (2023)
Informed consent is a process in which the patient is supported in developing an understanding of medical options. View the Ethics Committee Opinion
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
Unlisted Fertility Treatment CPT Code
Can you please refer me to an unlisted management CPT code for fertility treatment? View the Answer
Pregnancy Of Unknown Location
What is the most appropriate ICD-10 code for pregnancy of unknown location (not an ectopic pregnancy)? View the Answer
Limited Monitoring Ultrasound
What is the appropriate code to use for a limited follow-up follicular transvaginal ultrasound? View the Answer
Limited Transvaginal Ultrasound
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
In Vitro Maturation
Have CPT codes been established for maturation in vitro? View the Answer
IUI Same Gender
When managing an IUI or IVF cycle for a female same sex couple or a patient that has no exposure to sperm, what ICD 10 diagnosis should be used? View the Answer
IVF Case Rates
What ICD-10 codes apply to case rates? View the Answer
Monitoring E&M
Our group would like to know if others are billing an evaluation and management code for ultrasound and blood draw visits? View the Answer
Monitoring FET
What is the correct diagnosis code to use on the follicle ultrasound (76857) for a patient who is undergoing frozen embryo transfer (FET)? View the Answer
Monitoring Ovulation Induction By Nurses
We are considering the use of CPT code 99211 for encounters during cycle management as part of ovulation induction. 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
Embryo Storage Fees For Multiple Cycles
We bill embryo storage 89342 for a year's storage. View the Answer
Endometrial Receptivity Analysis
Our physicians are going to start doing an Endometrial Receptivity Analysis. Do you know the appropriate CPT code that should be used?View the Answer
Flat Fee For Outside Monitoring
Can our office charge outside monitoring patients a flat fee to be seen? 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 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
Coding For Placement Of A Cervical Stitch
Physicians at our practice are placing a stitch and dilating the cervix after egg retrievals for those patients that have cervical stenosis. View the Answer
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? 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
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
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
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
Journal Club Global: Evidence for Immunologic Therapies in Women Undergoing ART
Reproductive immunology is perhaps one of the most controversial and promising fields within ART. View the Video
Comprehensive guidance for human embryology, andrology, and endocrinology laboratories: management and operations: a committee opinion (2022)
ASRM has published guidance and minimum standards for embryology and andrology laboratories. 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
Journal Club Global - Fertilization rate as a novel indicator in ART results
This Journal Club Global discusses a provocative article recently published in Fertility and Sterility, discussing the results of a multicenter retrospective cohort study with the objective to appraise the fertilization rate as a predictive factor for cumulative live birth rate (CLBR). View the Video
Journal Club Global - Are We Approaching Automation in ART?
Some ART diagnostic devices are already available and offer objective tools of evaluation. 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
Minimum standards for practices offering assisted reproductive technologies: a committee opinion (2021)
A framework for assisted reproductive technology (ART) programs that meet or exceed the requirements suggested by the Centers for Disease Control View the Committee Opinion
Role of tubal surgery in the era of assisted reproductive technology: a committee opinion (2021)
This document reviews surgical options for reparative tubal surgery and the factors that must be considered when deciding between surgical repair and IVF.View the Committee Opinion
Journal Club Global - Recurrent Implantation Failures in ART: Myth or Reality?
Classically, implantation failures in ART were believed to result from alterations in embryo or endometrium quality.
View the Video
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
Correct coding for laboratory procedures during assisted reproductive technology cycles
This document provides updated coding information for services related to assisted reproductive technology procedures. View the Coding Committee Document
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
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 GuidelineTopic Resources
View more on the topic of insurance
Appropriate Use of Modifier -25
Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the Answer
Billing for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the Answer
ASRM on Increased Availability of Fertility Coverage for Federal Employees
We are pleased with the news shared by OPM today showing more carriers will be providing infertility benefits to federal employees in the coming year.
View the Press Release
Nation’s Leading Professional Group for Fertility Care Professionals Calls for Passage of Right to IVF Act
ASRM applauds Majority Leader Schumer’s decision to seek reconsideration of the Right to IVF Act.
View the Press Release
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: View the Answer
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
ASRM Responds to Senate Vote on IVF Bill
ASRM is disappointed that a filibuster prevented the passage of the Right to IVF Act.
View the Press Release
ASRM Calls for Passage of Family Building Bill
It would increase access to IVF treatments for all Americans, including active-duty service members, veterans, and federal employees.
View the Press Release
Mandated states and egg retrieval
What name should you use to submit for reimbursement for the actual egg donor when there is benefit for the donor egg retrieval? View the Answer
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
Endometrioma
Surgery was performed under anesthesia for Aspiration of right hyrosalpinx fluid and right endometrioma. 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
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
Unlisted Fertility Treatment CPT Code
Can you please refer me to an unlisted management CPT code for fertility treatment? 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
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
Embryo Culture Denied As Experimental
We have received denials from insurance payers when billing CPT code 89251. View the Answer
Flat Fee For Outside Monitoring
Can our office charge outside monitoring patients a flat fee to be seen? View the Answer
Frozen Embryo Transport
What is the code for the cost of frozen embryo transport? 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
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 Cryopreservation Of Embryos Under The Male Partner
Can 89258 be billed under the male partner of a female patient? 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
Claim Form for Donor Egg Retrieval
What bill form is used of IVF donor egg retrieval? 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
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
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
Male Infertility
A summary of common codes for Male Infertility 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
