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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View more on the topic of embryo transfer
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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
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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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What CPT code should be used for a “scratch test”? 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
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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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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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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
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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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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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Guidance on the limits to the number of embryos to transfer: a committee opinion (2021)
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Minimum standards for practices offering assisted reproductive technologies: a committee opinion (2021)
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Journal Club Global - Recurrent Implantation Failures in ART: Myth or Reality?
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The International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)
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Recommended practices for the management of embryology, andrology, and endocrinology laboratories: a committee opinion (2014)
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Best practices of ASRM and ESHRE: a journey through reproductive medicine (2012)
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Caitlin Hebert discusses fertility counseling, the importance of carrier screening, and overcoming barriers for patients while highlighting the role of genetic counseling. View the ASRMed Talk Video
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Preimplantation genetic testing for adult-onset monogenic diseases is ethically allowed when fully penetrant or conferring disease predisposition. View the Committee Opinion
Codes for Embryo Biopsy
When doing a preimplantation genetic test (PGT) biopsy, can you bill for each day a biopsy is performed or can you only bill once for the cycle? View the Answer
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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
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
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
Genetics: Is Expanded Carrier Screening the Standard of Care?
Hannah Green, a genetic counselor at NYU, discusses the benefits and limitations of expanded carrier screening, highlighting its impact on clinical practice and patient care. View the ASRMed Talk Video
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Danielle Soltesz of RMA New York discusses the complex economics and ethical considerations of genetic testing in reproductive medicine, exploring costs, patient care, and sustainability. View the ASRMed Talk Video
Clinical management of mosaic results from preimplantation genetic testing for aneuploidy of blastocysts: a committee opinion (2023)
This document incorporates studies about mosaic embryo transfer and provides evidence-based considerations for embryos with mosaic results on PGT-A. View the Committee Opinion
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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
Indications and management of preimplantation genetic testing for monogenic conditions: a committee opinion (2023)
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Results Review
What CPT code is most appropriate to submit for Physician Time to review CCS/PGS/PGD results? View the Answer
Sperm DNA Fragmentation
Is there a CPT code for HALO DNA Fragmentation for sperm? View the Answer
ICSI and Embryo Biopsy
How to bill for ICSI or embryo biopsies that occur in different days? View the Answer
Embryo Biopsy
Have any new codes been introduced for the lab portion of PGT? View the Answer
Embryo Biopsy Embryologist Travel Costs
Can we bill insurance for the biopsy procedure? Can we bill for travel expenses? View the Answer
Embryo Biopsy PGS Testing
What codes are appropriate for PGS testing? View the Answer
Genetic Counseling
Does ASRM have any guidance for how to bill for genetic counseling services provided by a genetic counselor?View the Answer
Assisted Zona Hatching
Can assisted hatching and embryo biopsy for PGT-A; PGT-M or PGT-SR be billed during the same cycle? View the Answer
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PGT-A by trophectoderm biopsy aims to select available euploid embryos for transfer. View the Video
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The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability. View the Committee Opinion
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One of the highest aspirations in reproductive medicine is to develop a technology allowing for ID of embryos that have true reproductive potential.
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Disclosure of sex when incidentally revealed as part of preimplantation genetic testing (PGT): an Ethics Committee opinion (2018)
Clinics may develop a policy to disallow selecting which embryos to transfer based on sex and choose to use only embryo quality as selection criteria. View the Committee Opinion
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 Guideline
