Monitoring E&M
Our group would like to know if others are billing an evaluation and management code for ultrasound and blood draw visits?
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
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.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 assisted reproductive technologies
Use of preimplantation genetic testing for monogenic adult-onset conditions: an Ethics Committee opinion (2024)
Preimplantation genetic testing for monogenic diseases for adult-onset conditions is ethically permissible for various conditions, including when the condition is fully penetrant or confers disease predisposition. View the Committee Opinion
When to use code Z31.83
When a patient is completing an approved fertility cycle, is it necessary View the Answer
Timed Intercourse Cycle Codes
Is it appropriate to utilize codes N97.8 or View the Answer
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: View the Answer
Journal Club Global: Falha de implantação: realidade ou ilusão estatística?
Fertility and Sterility Global Journal Club from Brazil View the Video
Fertility and Sterility On Air - TOC: July 2024
Articles this month include: predicting ART complications, laser assisted hatching on vitrified blastocysts, predictive models of miscarriage and more.Listen to the Episode
The use of hormonal contraceptives in fertility treatments: a committee opinion (2024)
Hormonal contraception aids in the timing of ART cycles, reduce ovarian cysts at IVF cycle initiation, and optimize visualization before hysteroscopy. View the Committee Opinion
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
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
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
Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2023)
Financial ‘‘risk-sharing’’ fee structures in programs charge patients a higher initial fee but provide reduced fees for subsequent cycles. View the Committee Document
IVF-assisted pregnancies constitute 2.5% of all births in 2022
In 2022, the number of babies born from IVF increased from 89,208 in 2021 to 91,771 in 2022. This means that 2.5% of births in the US are a result of ART.
View the Press Release
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
Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline (2023)
Ovarian hyperstimulation syndrome is a serious complication associated with assisted reproductive technology. View the guideline
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. View the Answer
Measurements to report with ultrasound codes
Are there clear guidelines as to what measurements are required in order to bill for each type of ultrasound? VIew the Answer
Billing for cryopreservation procedures on different days
I understand that if cryopreservation of oocytes is performed on two separate dates of service, each date of service was billable. View the Answer
Billing IVF lab work
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
Estradiol Free versus Total
Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? View the Answer
IVF coverage denied for Z31.83 diagnosis code
My wife and I have been seeking IVF treatment and coverage was added for infertility treatment (up to $25,000) but our insurer keeps denying it. View the Answer
Cycle coordination fees and 99499, S4042
I reviewed cycle coordination fees, but see that there is no specific code for cycle management. View the Answer
Supervising provider for embryology billing
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
The International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)
Terms and definitions currently used infertility care, infertility and medically assisted reproduction (MAR) can have different meanings that are dependent upon the setting, their usage in research or clinical interventions, or among diverse populations.View the Committee Joint Guideline
Journal Club Global - Revisiting the STAR trial: The Fellows debate PGT-A
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
Informed consent in assisted reproduction: an Ethics Committee opinion (2023)
Informed consent is a process in which the patient is supported in developing an understanding of medical options. View the Ethics Committee Opinion
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
I am trying to understand better when to use the procreative management code vs the fertility preservation counseling and procedure codes. View the Answer
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
Flat Fee For Outside Monitoring
Can our office charge outside monitoring patients a flat fee to be seen? 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
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
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
Board Certified Vs. Non-Board Certified Billing
Is coding/billing any different when a non-board certified or non-REI provider submits for REI procedure? View the Answer
Coding For Placement Of A Cervical Stitch
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
Reproductive immunology is perhaps one of the most controversial and promising fields within ART. View the Video
Comprehensive guidance for human embryology, andrology, and endocrinology laboratories: management and operations: a committee opinion (2022)
ASRM has published guidance and minimum standards for embryology and andrology laboratories. View the Committee Opinion
Journal Club Global - Best Practices of High Performing ART Clinics
This Fertility and Sterility Journal Club Global discusses February’s seminal article, “Common practices among consistently high-performing in vitro fertilization programs in the United States: a 10 year update.” View the Video
Journal Club Global - Fertilization rate as a novel indicator in ART results
This Journal Club Global discusses a provocative article recently published in Fertility and Sterility, discussing the results of a multicenter retrospective cohort study with the objective to appraise the fertilization rate as a predictive factor for cumulative live birth rate (CLBR). View the Video
Journal Club Global - Are We Approaching Automation in ART?
Some ART diagnostic devices are already available and offer objective tools of evaluation. View the Video
Guidance on the limits to the number of embryos to transfer: a committee opinion (2021)
ASRM's guidelines for the limits on the number of embryos to be transferred during IVF cycles have been further refined ... View the Committee Opinion
Role of tubal surgery in the era of assisted reproductive technology: a committee opinion (2021)
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?
Classically, implantation failures in ART were believed to result from alterations in embryo or endometrium quality.
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
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
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 infertility
Use of preimplantation genetic testing for monogenic adult-onset conditions: an Ethics Committee opinion (2024)
Preimplantation genetic testing for monogenic diseases for adult-onset conditions is ethically permissible for various conditions, including when the condition is fully penetrant or confers disease predisposition. View the Committee Opinion
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
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
Timed Intercourse Cycle Codes
Is it appropriate to utilize codes N97.8 or View the Answer
Appropriate Use of Modifier -25
Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the Answer
The use of preimplantation genetic testing for aneuploidy: a committee opinion (2024)
PGT-A use in the U.S. is rising, but its value as a routine IVF screening test is unclear, with mixed results from various studies. View the Committee Opinion
Fertility Support and AI: Help or Hinderance
Discover how fertility apps impact patient care and nursing staff. Explore the balance between tech and human touch in complex fertility treatments View the ASRMed Talk Video
National Infertility Awareness Week
April 20-26, 2025, is National Infertility Awareness Week (NIAW)!
View the NIAW Toolkit
Fertility and Sterility On Air - Seminal Article: Ernest Ng and Zhi Chen
June issue Seminal Contribution: a randomized controlled trial studying the use of progestins for ovulation supression in predicted high responders. Listen to the Episode
ASRM announces support for HOPE with Fertility Services Act
The American Society for Reproductive Medicine is proud to endorse the HOPE with Fertility Services Act (HR 8821).
View the Press Release
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
Subclinical hypothyroidism in the infertile female population: a guideline (2024)
This guideline reviews the risks and benefits of treating subclinical hypothyroidism in female patients with a history of infertility and miscarriage. View the Committee Guideline
Survey shows strong support for increased access to fertility treatments
A new public opinion poll reveals strong support for improved access to In Vitro Fertilization (IVF).
View the Press Release
Infertility Awareness
In honor of National Infertility Awareness Week (NIAW), we have rounded up some of our resources on infertility. View infertility resources
Leave Your Mark! NIAW April 21-27
National Infertility Awareness Week Action Round-Up Click here to leave your mark during NIAW2024
National Infertility Awareness Week 2024: Leave Your Mark
Next week is National Infertility Awareness Week, a federally recognized health observance founded to increase awareness of infertility.
View the Press Release
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
Journal Club Global: The future of REI Fellowship training: debating opportunities and threats
This exciting collaboration discusses the controversy and future directions for the field of Reproductive Endocrinology and Infertility medicine. View the Video
Journal Club Global: Infertility and Subclinical Hypothyroidism
The impact of treating SCH on fertility, obstetric outcomes, and offspring neurocognitive development is debated in the literature. View the Video
Ethical obligations in fertility treatment when intimate partners withhold information from each other: an Ethics Committee opinion (2024)
Clinicians should encourage disclosure between intimate partners but should maintain confidentiality where there is no harm to the partner and/or offspring. View the Committee Opinion
Ethical considerations for telemedical delivery of fertility care: an Ethics Committee opinion (2024)
Telemedicine has the potential to increase access to and decrease the cost of care. View the Committee Opinion
Definition of infertility: a committee opinion (2023)
‘‘Infertility’’ is a disease, condition, or status characterized by several factors. View the 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
Journal Club Global - Actualización en la suplementación con progesterona en fase lútea para transferencias de embriones congelados
Efectividad del rescate de progesterona en mujeres que presentan niveles bajos de progesterona circulante alrededor del día de la transferencia de embriones View the Video
Endometriosis and infertility: a committee opinion (2012)
Women with endometriosis typically present with pelvic pain, infertility, or an adnexal mass, and may require surgery. View the Committee Opinion
The International Glossary on Infertility and Fertility Care, 2017†‡§ (2017)
Terms and definitions currently used infertility care, infertility and medically assisted reproduction (MAR) can have different meanings that are dependent upon the setting, their usage in research or clinical interventions, or among diverse populations.View the Committee Joint Guideline
Surgery Coding
I took the ASRM coding course, and in that course, coding for bilateral neosalpingostomies was coded using only a dx of N70.11 (hydrosalpinx). 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
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
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
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
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
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
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
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
Initial Visit for Infertility With No Mandated Coverage
What code would be appropriate for an initial visit for infertility? 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
Hysteroscopy Recurrent Implantation Failure
What is the appropriate ICD-10 code for recurrent implantation failure? 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
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
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
ASRM müllerian anomalies classification 2021
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
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
Moving innovation to practice: an Ethics Committee opinion (2021)
The introduction of new strategies, tests, and procedures into clinical practice raises challenging ethical issues. View the Committee Opinion
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
Fertility treatment when the prognosis is very poor or futile: an Ethics Committee opinion (2019)
The Ethics Committee recommends that in vitro fertilization (IVF) centers develop patient-centered policies regarding requests for futile treatment. 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
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
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
Child-rearing ability and the provision of fertility services: an Ethics Committee opinion (2017)
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
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
