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Male Infertility


A summary of common codes for Male Infertility compiled by the ASRM Coding Committee.

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Coding Q&A

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Mental-health Services During Assisted Reproduction

A summary of codes for Mental-health Services During Assisted Reproduction compiled by the ASRM Coding Committee.
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PCOS

A summary of codes for PCOS as compiled by the ASRM Coding Committee.
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Recurrent Pregnancy Loss (RPL)

Strategy for coding for a patient with RPL - codes compiled by the ASRM Coding Committee. 
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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.

Coding Corner


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


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The ASRM Müllerian Anomaly Classification 2021 (MAC2021) includes cervical and vaginal anomalies and standardize terminology within an interactive tool format.

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These guidelines have been developed by the ASRM Practice Committee to assist physicians with clinical decisions regarding the care of their patients.

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

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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.

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COVID-19 Resources

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

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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 male fertility and andrology
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ASRM Today: Equity, Access, and Innovation, Episode Eight: 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
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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
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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
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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
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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
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TESE test thaws

We perform test thaws to determine if frozen TESE specimens from other clinics are suitable for our procedures. 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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Improving the Patient Experience - Male

Male factor evaluation is essential in diagnosing infertility causes, enhancing ART outcomes, and improving patient confidence. Learn why this assessment matters.. View the ASRMed Talk Video
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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
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A Few Good Sperm: The Critical Role of the Male Reproductive Urologist

REI consults involve thorough female evaluations with recommended male infertility assessment, including semen analysis per ASRM guidelines and urology referrals. View the ASRMed Talk Video
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Testing With No History of Infertility

What diagnosis codes should  providers submit to insurance carriers while trying to evaluate fertility issues? View the Answer
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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
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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
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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
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Male Consult

My group was wondering if and how to code for a male partner consultation.  View the Answer
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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
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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
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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
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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
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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
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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
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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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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
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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

Topic Resources

View more on the topic of insurance
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Fertility and Sterility On Air - Live from ASRM 2024: Part 2

Dive into the latest discussions on male fertility testing, U.S. insurance mandates for fertility treatments, and advancements in frozen embryo transfer research. Listen to the Episode
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Appropriate Use of Modifier -25

Is Modifier -25 appropriate in the monitoring cycle when an ultrasound View the Answer
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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
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ASRM on Increased Availability of Fertility Coverage for Federal Employees

We are pleased with the news shared by OPM today showing more carriers will be providing infertility benefits to federal employees in the coming year.

View the Press Release
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Nation’s Leading Professional Group for Fertility Care Professionals Calls for Passage of Right to IVF Act

ASRM applauds Majority Leader Schumer’s decision to seek reconsideration of the Right to IVF Act.

View the Press Release
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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
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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
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ASRM Responds to Senate Vote on IVF Bill

ASRM is disappointed that a filibuster prevented the passage of the Right to IVF Act.

View the Press Release
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ASRM Calls for Passage of Family Building Bill

It would increase access to IVF treatments for all Americans, including active-duty service members, veterans, and federal employees.

View the Press Release
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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? View the Answer
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Billing 58558 together with 58560

Can CPT codes 58558 and 58560 be billed together? Also, can 58560 be billed with place of service 11? View the Answer
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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
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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
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Reimbursement for cost of donor egg

My wife and I are going through a fertility treatment process, and we have purchased a donor egg out-of-pocket from a donor bank.  View the Answer
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Coding for Ovarian tissue cryopreservation, experimental or not?

For Cryopreservation; Reproductive Tissue Ovarian- 0058T code is not being recognized. Is there an updated one being used or a replacement of this code? View the Answer
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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
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Billing 58558 and 58560 together

Can CPT codes 58558 and 58560 be billed together? Also, can 58560 be billed with place of service 11? View the Answer
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Endometrioma

Surgery was performed under anesthesia for Aspiration of right hyrosalpinx fluid and right endometrioma. View the Answer
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Total versus Free estradiol

Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)? View the Answer
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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
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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
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Unlisted Fertility Treatment CPT Code

Can you please refer me to an unlisted management CPT code for fertility treatment? View the Answer
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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
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Initial Visit for Infertility With No Mandated Coverage

What code would be appropriate for an initial visit for infertility?  View the Answer
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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
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Embryo Culture Denied As Experimental

We have received denials from insurance payers when billing CPT code 89251.  View the Answer
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Flat Fee For Outside Monitoring

Can our office charge outside monitoring patients a flat fee to be seen?  View the Answer
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Frozen Embryo Transport

What is the code for the cost of frozen embryo transport? View the Answer
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Global Billing Vs Billing Under Provider

For an IVF cycle (that is not being billed global to an insurance plan) is it appropriate to bill the charges under one “global” provider? View the Answer
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Diagnosis Codes For Intrauterine Insemination (IUI)

I was reviewing your Coding Corner information to find a definitive diagnosis for IUI procedures. Which diagnosis is the most appropriate? View the Answer
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Donor Egg-Retrieval On Recipient's Claim

Is the donor egg retrieval included on the bill to insurance with the first IVF treatment for the recipient?  View the Answer
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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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Billing For Cryopreservation Of Embryos Under The Male Partner

Can 89258 be billed under the male partner of a female patient? View the Answer
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Billing For Procedures Performed By Outside Physicians

Our physician tested positive for COVID-19, so another physician not associated with our office performed our egg retrievals and embryo transfers.  View the Answer
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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
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Claim Form for Donor Egg Retrieval

What bill form is used of IVF donor egg retrieval? View the Answer
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Coding For Alpha-Fetoprotein Testing

My clinic is looking into implementing Alpha-Fetoprotein (AFP) testing. I understand there is currently no CPT code listed for this testing. View the Answer
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Coding For Donor Egg Retrieval For Male Intended Parent

In coding a donor-egg retrieval to bill to insurance under the male intended parent, would it be appropriate to use the Z31.83?  View the Answer
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Coding For Long-Term Storage Of Embryos

We have recently been contacted by a payer stating we have a patient whose plan will cover long-term storage of her embryos. View the Answer
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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
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PCOS

A summary of codes for PCOS as compiled by the ASRM Coding Committee. View the Coding Summary
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Recurrent Pregnancy Loss (RPL)

Strategy for coding for a patient with RPL - codes compiled by the ASRM Coding Committee.  View the Coding Summary
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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
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Embryo Transfer

A summary of Embryo Transfer codes collected by the ASRM Coding Committee View the Coding Summary
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Endometriosis

A summary of common codes for Endometriosis compiled by the ASRM Coding Committee View the Coding Summary
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Fibroids

A summary of codes to use with fibroids and myomas compiled by the ASRM Coding Committee View the Coding Summary
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Fertility Preservation

A summary of codes for Fertility Preservation compiled by the ASRM Coding Committee. View the Coding Summary
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Jan 2022: Modifier 93 – Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System

At the September 2021 CPT Editorial Panel Meeting, a new Modifier was accepted to describe real-time telemedicine services. View the Letter
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Feb 2021: CMS holds physicians harmless from Merit-based Incentive Payment System (MIPS) penalties amid COVID-19 Public Health Emergency

CMS announced it will hold physicians harmless from up to 9% MIPS penalties due to the significant disruptions of the COVID-19 public health emergency. View the Letter
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Jan 2021: Coding for COVID-19 Vaccine Administration

AMA has published an update to the Current Procedural Terminology (CPT®) code set that includes new vaccine-specific codes to report immunizations. View the Letter
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Jan 2021: Telehealth Coding Extension and 2021 Medicare Physician Fee Schedule

Effective January 11, 2021, the U.S. Department of Health and Human Services' Secretary Azar has extended the COVID-19 Public Health Emergency (PHE). View the Letter
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Dec 2020: New Evaluation and Management Codes for 2021

Effective January 1, 2021, Evaluation and Management Codes will be changed for office visits only.  View the Link