Billing both partners for 99205 initial consultation
In a postgraduate coding course, 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. After that conference, our practice created a workflow to make sure that charge slips were created for both partners and discontinued this practice due to high deductible plans impacting our patients negatively.
- Is it still compliant to submit for the consultation code on both partners if they both present for the consultation?
- How does this apply to same-sex couples? If a female same-sex couple presents and both females desire to have evaluation for consideration in treatment, can/should 99205 be submitted to both partners' insurance?
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
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 female fertility
Documentation for ultrasound coding 76830
Regarding billing code 76830: it “includes imaging of the uterus, endometrium, fallopian tubes, ovaries, and pelvic structures such as the bladder, as indicated. View the Answer
Is There a Test for Fertility?
This video explains the concept of ovarian reserve and the limitations of fertility tests, emphasizing that ovarian reserve does not equal fertility. View the ASRMed Talk Video
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
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
Exclusion of IVF services due to Z31.83
My wife and I have been seeking IVF treatment and this year coverage was added to my benefits for infertility treatment (up to $25,000). View the Answer
Interactive MAC Tool
Explore the diagnosis of a 15-year-old with right-sided pain using the ASRM Mac Tool to assess uterine anomalies, including uterus didelphys with obstructed hemivagina. View the ASRMed Talk Video
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
Testing With No History of Infertility
What diagnosis codes should providers submit to insurance carriers while trying to evaluate fertility issues? View the Answer
Transvaginal Cyst Aspiration
If a cyst aspiration is completed in office, what codes could be used for this service in a clinic setting? View the Answer
Sperm Wash No Male Factor
What would be the best code to use for a sperm wash when it is not a male factor issue? View the Answer
Post Vasectomy Infertility
If a husband has had a vasectomy, does the sterilization code apply to the wife's visits? 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
Ovulation Induction Monitoring With PCOS
We have a patient insisting that we code the ultrasound follicle monitoring with the PCOS diagnosis. 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
Optimizing natural fertility: a committee opinion (2022)
This committee opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples... View the Committee Opinion
Diagnosis and treatment of luteal phase deficiency: a committee opinion (2021)
Luteal phase deficiency (LPD) is a clinical diagnosis associated with an abnormal luteal phase length of %10 days.View the Committee Opinion
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
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
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
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
Uterus Transplantation Intersociety Roundtable (2016)
A Roundtable to discuss the development of uterus transplantation in the United States was convened under the sponsorship of ASRM and ASRT. View Roundtable discussion
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
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 male fertility and andrology
ASRM Today: Equity, Access, and Innovation, Episode Seven: ASRM 2024 Preview Part Two
Explore key sessions at ASRM 2024, including mental health in fertility care, male infertility research, and equitable contraceptive access. Join the discussions in Denver. Listen to the Episode
AUA Releases Male Infertility Guideline Amendment
The AUA, in collaboration with the American Society for Reproductive Medicine (ASRM), has released the 2024 amendment to the Male Infertility Guideline.
View the Press Release
Billing for the partner workup
Are most practices in REI billing male partners for their history? We also order labs and sperm count on all male partners. View the Answer
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
TESE test thaws
We perform test thaws to determine if frozen TESE specimens from other clinics are suitable for our procedures. View the Answer
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
Diagnostic evaluation of sexual dysfunction in the male partner in the setting of infertility: a committee opinion (2023)
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
Testing With No History of Infertility
What diagnosis codes should providers submit to insurance carriers while trying to evaluate fertility issues? View the Answer
Semen Analysis For Assessment of Fertility
What is the appropriate diagnostic code to use for a semen analysis for the assessment of infertility? View the Answer
Post Vasectomy Infertility
If a husband has had a vasectomy, does the sterilization code apply to the wife's visits? View the Answer
Lab RVUs
Is there a list of RVUs for embryology and andrology laboratory procedures, and if so, where can it be found? View the Answer
Male Consult
My group was wondering if and how to code for a male partner consultation. 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
Male Infertility
A summary of common codes for Male Infertility compiled by the ASRM Coding Committee. View the Coding Summary
Journal Club Global Live from PCRS - ICSI for Non-Male Factor Infertility
While intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of male factor infertility, a significant controversy still remains regarding its ubiquitous use in all IVF cycles. View the Video
Optimizing natural fertility: a committee opinion (2022)
This committee opinion provides practitioners with suggestions for optimizing the likelihood of achieving pregnancy in couples... 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
Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I (2021)
Part I outlines the appropriate evaluation of the male in an infertile couple. View the Guideline
Diagnosis and Treatment of Infertility in Men: AUA/ ASRM Guideline Part II (2021)
The summary presented is Part II of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. View the Guideline
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
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
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 RecommendationTopic Resources
View more on LGBTQIA+ issues
Fertility Care Gets Important Win in California
ASRM celebrates California's SB 729, expanding IVF coverage for same-sex couples and singles, advancing equitable fertility care access.
View the Press Release
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
Diagnosis code for donation
What is the diagnosis code for an embryo donation versus egg donation? View the Answer
Transgender Care
I have a question about a patient who is a transgender male to female. 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
Diagnosis Code For Same-Sex Egg Donation
We have a same-sex male couple with insurance coverage for IVF. View the Answer
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
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
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
