Testing With No History of Infertility
I came across your site as I was trying to do some research on what diagnosis codes providers should submit to insurance carriers while trying to evaluate fertility issues. If the prescriber is trying to determine if the female has infertility and must run diagnostic tests (IE lab work, HSG, ultrasound, etc...) that the patient has not obtained previously, and the patient does not have a diagnosis of "female infertility" from another OB-GYN, is it appropriate that the doctor use the diagnosis code of "female infertility" without knowing any results of lab work or a HSG to confirm infertility? Rather, should a diagnosis code that states that the patient is being evaluated for fertility issues, be used instead?
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Coding Q&A
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What diagnosis codes should providers submit to insurance carriers while trying to evaluate fertility issues? View the Answer
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Testing With No History of Infertility
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The Z31.41 is or is not the correct code to use for diagnostic testing of an infertile couple? And If so can if be used as the primary and only code? View the Answer
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Appropriate Use of Modifier -25
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Billing for E/M Visits
When billing Evaluation & Management (E/M) visits based on medical decision-making, would we View the Answer
When to use code Z31.83
When a patient is completing an approved fertility cycle, is it necessary View the Answer
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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? View the Answer
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Tobacco or marijuana use and infertility: a committee opinion (2023)
In the United States, approximately 21% of adults report some form of tobacco use, although 18% report marijuana use. View Committee Opinion
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Defines infertility as a disease impacting reproductive function, guiding evaluation and inclusive treatment regardless of age, status, or orientation. View the Committee Opinion
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It is the responsibility of the clinician to assess for erectile dysfunction, ejaculatory dysfunction, or diminished libido in men presenting for infertility. View the Committee Opinion
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Post Vasectomy Infertility
If a husband has had a vasectomy, does the sterilization code apply to the wife's visits? View the Answer
Pregnancy Of Uncertain Viability Ultrasound
My staff is telling me that I am getting reimbursed for the first sonogram and OB visit (using ICD 10 code for pregnancy of uncertain viability – O36.80X0. View the Answer
Pregnancy Ultrasound
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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
Self-referred New Patient
A patient self-refers to our physician for an initial new patient consultation instead of referred by another physician, how do we code for the consult? View the Answer
Surgery Coding
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Telephone Consult
Does a physician need to speak directly to a patient to code for a telephone consult (99371-99373) or can a staff member relay physician notes to patients? View the Answer
Testing With No History of Infertility
What diagnosis codes should providers submit to insurance carriers while trying to evaluate fertility issues? View the Answer
Infertility Consult
Does ASRM have any examples of evaluation and management documentation for patients being seen for an initial infertility evaluation? View the Answer
Infertility Consult by Nurse
What code is used for a nurse practitioner seeing a fertility patient for the first time? View the Answer
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What code would be appropriate for an initial visit for infertility? View the Answer
IUI or IVF
Should other ovarian dysfunction (diagnosis code E28.8) or unspecified ovarian dysfunction (diagnosis code E28.9) can be used for an IUI or an IVF cycle 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
New vs Established Patient
How soon can you bill as a new infertility patient? View the Answer
General E&M Consult
Recently we have received a “re-code” on a new patient (we billed a 99203 and the insurance re-coded it to a 99213). View the Answer
Hysteroscopy Recurrent Implantation Failure
What is the appropriate ICD-10 code for recurrent implantation failure? 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
Diagnostic Testing of an Infertile Couple
The Z31.41 is or is not the correct code to use for diagnostic testing of an infertile couple? And If so can if be used as the primary and only code? View the Answer
Diagnosis of Infertility for IVF Procedure
How important is it to have accurate documentation of the type of infertility diagnosis for IVF procedures? View the Answer
Blood Draws
If a patient comes in only for a blood draw (venipuncture) and is seen only by the lab technician (not an MD, PA, or NP), may we bill for a (minimal) office visit? View the Answer
Blood Tests
Patients are requesting to have lab work drawn from the female patient moved to the males account due to the female fertility coverage being maxed out. View the Answer
Male Infertility
A summary of common codes for Male Infertility compiled by the ASRM Coding Committee. View the Coding Summary
Fertility evaluation of infertile women: a committee opinion (2021)
Diagnostic evaluation for infertility in women should be conducted in a systematic, expeditious, and cost-effective manner. View the Committee Opinion
ASRM müllerian anomalies classification 2021
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The introduction of new strategies, tests, and procedures into clinical practice raises challenging ethical issues. View the Committee Opinion
Intracytoplasmic sperm injection (ICSI) for non–male factor indications: a committee opinion (2020)
Intracytoplasmic sperm injection is frequently used in combination with assisted reproductive technologies. View the Committee Document
Use of exogenous gonadotropins for ovulation induction in anovulatory women: a committee opinion (2020)
Pretreatment evaluation, indications, treatment regimens, and complications of gonadotropin treatment. View the Committee Opinion
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)
Providers who care for women at risk for hereditary gynecologic cancers must consider the impact of these conditions. View the Joint Statement
Guidance for Providers Caring for Women and Men Of Reproductive Age with Possible Zika Virus Exposure (Updated 2019)
This ASRM guidance specifically addresses Zika virus infection issues and concerns of individuals undergoing assisted reproductive technologies (ART). View the Guideline
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The Ethics Committee recommends that in vitro fertilization (IVF) centers develop patient-centered policies regarding requests for futile treatment. View the Committee Opinion
American Society for Reproductive Medicine position statement on uterus transplantation: a committee opinion (2018)
Following the birth of the first child from a transplanted uterus in Gothenburg, Sweden, in 2014, other centers worldwide have produced scientific reports. View the Committee Opinion
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Fertility programs may withhold services on the basis that patients will be unable to provide minimally adequate or safe care for offspring. View the Committee Opinion
The International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)
A globally‑consensus glossary of 283 infertility and fertility‑care terms developed in 2017 to harmonize communication across clinicians, researchers & patients. View the Committee Joint Guideline
Removal of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline (2017)
This review evaluates if uterine myomas impact likelihood of pregnancy and pregnancy loss, and if myomectomy influences pregnancy outcomes. View the Guideline
Improving the Reporting of Clinical Trials of Infertility Treatments (IMPRINT): modifying the CONSORT statement (2014)
Clinical trials testing infertility treatments often do not report on the major outcomes of interest to patients and clinicians and the public. View the Guideline
