Coding for an endometrial biopsy/Mock cycle
Our center has been performing Mock/ERA cycle for a few years now. Patients without IVF coverage are private pay for this cycle. Recently we have had patients request for us to bill their insurance for the two monitoring visits and the Endo BX and change the diagnosis code to something that is payable. We are coding these cycles with Z31.83 as this cycle is in regards to preparation for a frozen embryo transfer at some point. Patients are asking us to change the icd10 code to Z31.41 as a diagnostic testing cycle. Our consents that patient sign state “consenting to uterine preparation for upcoming IVF/FET/Pride cycle” and our op note on Endo bx (58100) states “patient present today for endo bx due to: Enhanced implantation”. We do get many requests from carriers for records.
An ERA cycle is performed the same way a patient prepares for a frozen embryo transfer (FET). However, rather than performing an actual embryo transfer, an endometrial biopsy is performed. The biopsy assesses whether the uterine lining would have been receptive if an embryo transfer was performed.
I do know that the lab that performs the diagnostic testing portion does not bill insurance as they will not cover it. I want to make sure that our center is coding correctly.
An ERA cycle is performed the same way a patient prepares for a frozen embryo transfer (FET). However, rather than performing an actual embryo transfer, an endometrial biopsy is performed. The biopsy assesses whether the uterine lining would have been receptive if an embryo transfer was performed.
I do know that the lab that performs the diagnostic testing portion does not bill insurance as they will not cover it. I want to make sure that our center is coding correctly.
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Coding Q&A
View more Coding Q&A in this category
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?
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.
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.
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I have some infertility coverage, under which my insurance said they will cover frozen embryo shipping/transport from one facility to another.Coding Corner
Coding Corner is segmented into the following sections. Click an image below to view questions and answers in that section.
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At the meeting, we learned about the CPT code 76705-Ultasound guidance for embryo transfer, can this code be billed with CPT code 76942? View the Answer
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Can we use code 76998 for the ultrasound guidance as this patient is being seen in the Surgery Center? View the Answer
US Embryo Transfer-Transmyometrial
How would you code for an ultrasound- guided transvaginal-transmyometrial test transfer of embryo catheter? View the Answer
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Is there any specific CPT code(s) for uterine sounding? (Referring to cannulating the cervix and “sounding” or measuring the uterine height) View the Answer
CPT 89253 and 89254 for Assisted hatching
Can I bill CPT codes 89253 and 89254 together? If yes, do I need a modifier on any of the codes? View the Answer
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Can you advise the proper coding process for a trial transfer? View the Answer
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What ICD-10 codes apply to case rates? View the Answer
IVF Lab vs Physician Practice Billing
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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
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Have CPT codes been established for maturation in vitro? View the Answer
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What CPT code should be used for a “scratch test”? View the Answer
Embryo Thawing/Warming
Is it allowable to bill 89250 for the culture of embryos after thaw for a frozen embryo transfer (FET) cycle? View the Answer
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
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Has any progress been made in creating/obtaining a specific CPT code for an elective single embryo transfer (eSET)? 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
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Standardization improves performance and safety of embryo transfer View the Committee Opinion
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Semen analysis and thaw code
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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
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
IVF-assisted pregnancies constitute 2.5% of all births in 2022
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View the Press Release
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I reviewed cycle coordination fees, but see that there is no specific code for cycle management. View the Answer
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The International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)
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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
Z Codes Vs. Procedure Codes For Fertility Preservation Counseling
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Pregnancy Of Unknown Location
What is the most appropriate ICD-10 code for pregnancy of unknown location (not an ectopic pregnancy)? View the Answer
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
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
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
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
In Vitro Maturation
Have CPT codes been established for maturation in vitro? 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
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Can our office charge outside monitoring patients a flat fee to be seen? View the Answer
Diagnosis Code For Same-Sex Egg Donation
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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
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One of my physicians uses an outside facility to perform the retrievals and transfers. View the Answer
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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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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
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
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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
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
Journal Club Global - Recurrent Implantation Failures in ART: Myth or Reality?
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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
Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2016)
Financial ‘‘risk-sharing’’ fee structures in assisted reproduction programs charge patients a higher initial fee but provide reduced fees for subsequent cycles and often a partial or complete refund if treatment fails. View the Committee Document
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 genetic screening/testing
Fertility and Sterility On Air - TOC: May 2024
Topics this month include Iatrogenic and demographic determinants of the national plural birth increase, outcomes between ICSI and IVF with PGT-A. Listen to the Episode
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
Fertility and Sterility On Air - Unplugged: March 2024
Topics include: melatonin and implantation (4:38), whole-genome screening of embryos, and bioengineering assisted reproductive technology. Listen to the Episode
Journal Club Global: Cost effectiveness analyses of PGT-A
Infertility treatments can be financially burdensome, often without insurance coverage, making understanding the cost effectiveness of PGT-A crucial. View the Video
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
Coding PGT requisitions to the PGT lab
Do you have any recommended codes to use for PGT requisitions to the PGT lab? View the Answer
Clinical management of mosaic results from preimplantation genetic testing for aneuploidy of blastocysts: a committee opinion (2023)
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Journal Club Global - Revisiting the STAR trial: The Fellows debate PGT-A
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Is there a CPT code for HALO DNA Fragmentation for sperm? View the Answer
Results Review
What CPT code is most appropriate to submit for Physician Time to review CCS/PGS/PGD results? View the Answer
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How to bill for ICSI or embryo biopsies that occur in different days? View the Answer
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Does ASRM have any guidance for how to bill for genetic counseling services provided by a genetic counselor?View the Answer
Embryo Biopsy
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Can we bill insurance for the biopsy procedure? Can we bill for travel expenses? View the Answer
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What codes are appropriate for PGS testing? View the Answer
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Can assisted hatching and embryo biopsy for PGT-A; PGT-M or PGT-SR be billed during the same cycle? View the Answer
Indications and management of preimplantation genetic testing for monogenic conditions: a committee opinion (2023)
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Journal Club Global - PGT-A - Can non-invasive approaches based on spent medium analysis
PGT-A by trophectoderm biopsy aims to select available euploid embryos for transfer. View the Video
ASRM müllerian anomalies classification 2021
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Journal Club Global - Accuracy of Preimplantation Genetic Testing for Aneuploidies
One of the highest aspirations in reproductive medicine is to develop a technology allowing for ID of embryos that have true reproductive potential.
View the Video
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)
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Disclosure of sex when incidentally revealed as part of preimplantation genetic testing (PGT): an Ethics Committee opinion (2018)
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Use of preimplantation genetic testing for monogenic defects (PGT-M) for adult-onset conditions: an Ethics Committee opinion (2018)
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Transferring embryos with genetic anomalies detected in preimplantation testing: an Ethics Committee Opinion (2018)
Patient requests for transfer of embryos with genetic anomalies linked to serious health-affecting disorders detected in preimplantation testing are rare but do exist. View the Committee Document
Best practices of ASRM and ESHRE: a journey through reproductive medicine (2012)
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