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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? How do you identify the donor egg retrieval on the recipient’s claim?
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Coding Q&A

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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 Third Party teaser

Submitting female codes under a male patient in a donor cycle

We got a rejection from the clearinghouse for using a female diagnosis under a male patient. 
Coding Third Party teaser

Billing donor services to IP’s insurance

When an intended parent has donor coverage under their insurance, how do we bill the donor services to their insurance?

Coding Corner


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ASRM Ethics Opinions

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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Practice Guidance

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 egg donation
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
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Diagnosis code for donation

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

Fertility and Sterility On Air - Microdose Interview: Dr. Papri Sarkar and Dr. Phillip Romanski

Dr. Papri Sarkar and Dr. Phillip Romanski, discuss their recent article "Optimal antimüllerian hormone levels in oocyte donors: a national database analysis." Listen to the Episode
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Fertility and Sterility On Air - TOC: February 2024

Topics this month include the optimial AMH level in oocyte donors, the role of mean number of DNA breakpoints (MDB) in sperm DNA integrity, and more. Listen to the Episode
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Reimbursement for 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
Document Icon

Misconduct in third-party assisted reproductive technology by participants and nonmedical professionals or entities: an Ethics Committee opinion (2023)

In some instances, it is ethically permissible for the physician to either disclose material information to the affected party or to decline to provide or continue to provide care. View the Committee Opinion
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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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Billing egg donor’s retrieval to recipient’s insurance

How you would bill an egg donor’s retrieval to a patient’s insurance? View the Answer
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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
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IVF Case Rates

What ICD-10 codes apply to case rates? View the Answer
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Donor Screening

Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code?  View the Answer
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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
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Diagnosis Code For Same-Sex Egg Donation

We have a same-sex male couple with insurance coverage for IVF.  View the Answer
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Donor Egg Lot Acquisition

What is the code for egg lot acquisition? View the Answer
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Donor Eggs-Physical Exam

Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code?  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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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
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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 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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Updated terminology for gamete and embryo donors: directed (identified) to replace ‘‘known’’ and nonidentified to replace ‘‘anonymous’’: a committee opinion (2022)

ASRM encourages all stakeholders with an interest in gamete and embryo donation to adopt directed (identified). View the Committee Opinion
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Financial compensation of oocyte donors: an Ethics Committee opinion (2023)

Financial compensation of women donating oocytes for reproductive or research purposes is justified on ethical grounds. View the Committee Opinion
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Guidance regarding gamete and embryo donation (2021)

This document provides the latest recommendations for the evaluation of potential sperm, oocyte, and embryo donors as well as their recipients. View the Committee Opinion
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Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline (2021)

A review of success rates, factors that may impact success rates, and  outcomes. View the Committee Opinion
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Repetitive oocyte donation: a committee opinion (2020)

Donors should be advised of the number of cycles/donations that a given oocyte donor may undergo. View the Committee Opinion
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Oocyte or embryo donation to women of advanced reproductive age: an Ethics Committee opinion (2016)

Advanced reproductive age (ARA) is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications.  View the Committee Opinion

Topic Resources

View more on the topic of insurance
PR Bulletin Icon

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
PR Bulletin Icon

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
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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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Endometrioma

Surgery was performed under anesthesia for Aspiration of right hyrosalpinx fluid and right endometrioma. 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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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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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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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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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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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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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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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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Embryo Culture Denied As Experimental

We have received denials from insurance payers when billing CPT code 89251.  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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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 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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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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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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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 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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Male Infertility

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

Topic Resources

View more on the topic of third-party reproduction
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
Coding Icon

Submitting female codes under a male patient in a donor cycle

We got a rejection from the clearinghouse for using a female diagnosis under a male patient.  View the Answer
Coding Icon

Billing donor services to IP’s insurance

When an intended parent has donor coverage under their insurance, how do we bill the donor services to their insurance? View the Answer
Coding Icon

Reimbursement for 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
Document Icon

Misconduct in third-party assisted reproductive technology by participants and nonmedical professionals or entities: an Ethics Committee opinion (2023)

In some instances, it is ethically permissible for the physician to either disclose material information to the affected party or to decline to provide or continue to provide care. View the Committee Opinion
Document Icon

Defining embryo donation: an Ethics Committee opinion (2023)

The ethical appropriateness of patients donating embryos to other patients for  family building, or for research, is well established.
View the Committee Opinion
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Gestational Carrier

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

Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code?  View the Answer
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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
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Diagnosis Code For Same-Sex Egg Donation

We have a same-sex male couple with insurance coverage for IVF.  View the Answer
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Donor Egg Infectious Disease Lab Screening

The issue we are experiencing is outside labs billing with Z11.3 are getting denials stating improper ICD-10 for the services billed.  View the Answer
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Donor Egg Lot Acquisition

What is the code for egg lot acquisition? View the Answer
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Donor Eggs-Physical Exam

Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code?  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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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
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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