Registration now open for ASRM 2025!

Menu
Close Close Icon
Coding Corner general teaser

Third-party billing for an Embyo Transfer on a Gestational Carrier

The IP’s insurance plan has coverage for embryo transfer. Upon further clarification with the insurance plan, the IP has confirmed that the plan will cover not only the embryology codes, but also the codes which are performed to the GC, including ultrasound during transfer and embryo transfer. The plan representative is advising that the ultrasound and embryo transfer codes should be billed with the IP’s name on the claim, not the GC’s, stating that this is an acceptable practice so long as there is a coding modifier attached to demonstrate the embryo transfer was done on a GC.

Is it considered compliant to send out a claim to insurance for embryo transfer with the IP’s name as the person who the service was rendered to when the service was actually rendered to the GC, so long as the correct modifier is attached? If yes, what diagnosis code and what modifier would you attach to the embryo transfer cycle CPT codes?

Login now to view this Coding information. Coding Resources are available to ASRM Members only.

If you are not an ASRM member and would like to be, visit the Membership Tab above.

Coding Q&A

View more Coding Q&A in this category
Coding Third Party teaser

Third-party billing for an Embyo Transfer on a Gestational Carrier

The IP’s insurance plan has coverage for embryo transfer. Upon further clarification with the insurance plan, the IP has confirmed
Coding Third Party teaser

Mental health assessment for donors and intended parents

Is it appropriate to use 96156 or 96167 for mental health professional (MHP) counseling of gamete/embryo donors and gestational carriers?
Coding Third Party teaser

Diagnosis code for donation

What is the diagnosis code for an embryo donation versus egg donation?
Coding Third Party teaser

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?

Coding Corner


Coding Corner is segmented into the following sections. Click an image below to view questions and answers in that section.


Coding_Andrology_Teaser.png
Coding_ARTClinicalCare_Teaser.png
Coding_ART_Lab_Teaser.png
Coding_Surgery_Teaser.png


Coding_ThirdParty_Teaser.png
Coding Summaries_Teaser.png
Coding_ChairLetters_Teaser.png
Coding Documents_Teaser.png

More Resources

Practice Committee Documents teaser

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.

View ASRM Practice Documents
MAC 2021 teaser
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.

View the MAC Tool
Coding Corner general teaser
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.

View the Q & A
EMR Phrases teaser
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.

View the library
Ethics Committee teaser

ASRM Ethics Opinions

Ethics Committee Reports are drafted by the members of the ASRM Ethics Committee on the tough ethical dilemmas of reproductive medicine.

View ASRM Ethics Opinions
Covid-19 teaser
Practice Guidance

COVID-19 Resources

A compendium of ASRM resources concerning the Novel Corona virus (SARS-COV-2) and COVID-19.

View the resources
Couple looking at laptop for online patient education materials

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.

View Website

Topic Resources

View more on the topic of gestational carriers and surrogacy
Coding Icon

Third-party billing for an Embyo Transfer on a Gestational Carrier

The IP’s insurance plan has coverage for embryo transfer. Upon further clarification with the insurance plan, the IP has confirmed View the Answer
Coding Icon

Mental health assessment for donors and intended parents

Is it appropriate to use 96156 or 96167 for mental health professional (MHP) counseling of gamete/embryo donors and gestational carriers? View the Answer
Document Icon

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
Coding Icon

Diagnosis code for donation

What is the diagnosis code for an embryo donation versus egg donation? View the Answer
Videos Icon

Journal Club Global: Absolute uterine infertility a Cornelian dilemma: uterine transplantation or surrogacy?

Absolute uterine infertility presents as a Cornelian dilemma for patients and providers. View the Video
Coding Icon

Gestational Carrier

I would like to confirm ASRM’s opinion on the best code to use for a gestational carrier cycle.  View the Answer
Coding Icon

Diagnosis Code For Same-Sex Egg Donation

We have a same-sex male couple with insurance coverage for IVF.  View the Answer
Document Icon

Consideration of the gestational carrier: an Ethics Committee opinion (2023)

Intended parents engage with gestational carriers (GCs) to achieve their personal reproductive goals. View the Committee Opinion
Document Icon

Recommendations for practices using gestational carriers: a committee opinion (2022)

This document provides the latest recommendations for the screening, evaluation, and legal counseling of gestational carriers and intended parents. View the Committee Opinion

Topic Resources

View more on LGBTQIA+ issues
Coding Icon

Third-party billing for an Embyo Transfer on a Gestational Carrier

The IP’s insurance plan has coverage for embryo transfer. Upon further clarification with the insurance plan, the IP has confirmed View the Answer
Newspaper Icon

LGBTQ+ Researcher’s Dreams on hold after losing NIH Funding

Dr. Brent Monseur’s LGBTQ+ family-building research lost NIH funding. ASRM responds with emergency support to protect inclusive reproductive science. Learn more about Dr. Brent Monseur's research
Advocacy Icon

Just the Facts: Biological Sex

Biological sex is a complex, multidimensional construct influenced by anatomy, genetics, and hormones. Efforts to oversimplify it ignore scientific reality. View the advocacy resource
Coding Icon

Code O09.01 vs O09.811 for Pregnancy Patients

Is code O09.01 acceptable for all pregnancy patients, or for same-sex cases View the Answer
Coding Icon

Billing both partners for 99205 initial consultation

We discussed the ability to bill 99205 for an initial consultation on both the male and female partners if they both present for the consultation.  View the Answer
Document Icon

Inclusive language and environment to welcome lesbian, gay, bisexual, transgender, queer, questioning, intersex, and asexual+ patients (2024)

Creating an inclusive clinical environment to serve lesbian, gay, bisexual, transgender, queer, questioning, intersex, and asexual+ patients is vital. View the Commitee Opinion
Coding Icon

Diagnosis code for donation

What is the diagnosis code for an embryo donation versus egg donation? View the Answer
Coding Icon

Transgender Care

I have a question about a patient who is a transgender male to female. View the Answer
Coding Icon

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
Coding Icon

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 fertilized from male #2. View the Answer
Document Icon

Access to fertility treatment irrespective of marital status, sexual orientation, or gender identity: an Ethics Committee opinion (2021)

Individuals and couples should have access to fertility services irrespective of marital status, sexual orientation, or gender identity. View the Committee Opinion
Document Icon

Access to fertility services by transgender and nonbinary persons: an Ethics Committee opinion (2021)

The provision of fertility services to transgender individuals and the denial of access to fertility services is not justified. View the Committee Opinion
Membership Icon

LBGTQ Special Interest Group (LGBTQSIG)

The LGBTQ Special Interest Group exists to foster an environment of inclusivity for all potential parents to have a voice and an advocate within the ASRM. Learn more about the LGBTQSIG