All Coding Corner Questions
If you don't see your question pertaining to reproductive medicine answered, contact ASRM and we'll publish the answer in ASRM News and on the web. When submitting your question, please include your phone number.
Please note: it may take up to six weeks to receive an answer to your inquiry.
Answers to the CPT Coding Questions are available online only to ASRM Members. If you are a member and would like to view them, please
login. If you are not an ASRM member and would like to be,
click here.
Posted
Jan 13, 2021
How do I code for therapeutic donor insemination for an unmarried female with no known fertility issues except no partner?
Posted
Mar 28, 2022
We bill embryo storage 89342 for a year's storage. We use the rule of thumb, we only bill one year of storage per specimen, not by cycle. For example, a patient has a retrieval on 11/10/2020 and we billed 89342 for a year of storage and received payment from insurance.
Patient came back for another retrieval on 3/16/21, and storage 89342 was billed for that cycle. Patient now has embryos from two cycles in storage. Should we void the March 2021 storage and bill insurance again for another year of storage for 11/2021?
Posted
Jan 13, 2021
We are seeing conflicting information about the correct ICD-10 diagnosis code for the CPT 58322, Artificial l Insemination, Intra-uterine.
Most of our coding books recommend N97.0 or N97.8, but we have encountered other literature that suggests the use of the ICD-10 PCS code of 3E0P3LZ or 3E0P7LZ.
Posted
Jan 13, 2021
Our practice would like some guidelines on whether other ovarian dysfunction (diagnosis code E28.8) or unspecified ovarian dysfunction (diagnosis code E28.9) can be used as the sole diagnosis code for an IUI or an IVF cycle. Are the documentation requirements any different than just N97.9?
Posted
Jan 13, 2021
In our office, nurses perform the IUI and credit the ordering physician.
We have the following questions:
- Are there any legal concerns with malpractice in having the nurse perform these services instead of the physician?
- Can we bill an insurance company for an IUI performed by an RN?
- Must the physician be physically present in the office at the time of the IUI in order to bill for the service?
Posted
Jan 13, 2021
At our center, the intrauterine inseminations are performed by our nurses. At the time of the insemination our nurse assesses the patient for any symptoms, reviews an instruction sheet that educates the patient about the symptoms of ovarian hyperstimulation, tells the patient when to come in for the pregnancy test, and reviews any additional physician instructions. In addition to the standard charges for the insemination and sperm prep, can we also bill the evaluation management code 99211 with a modifier (-25)?
Posted
Jan 13, 2021
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?
Posted
Jan 13, 2021
What is the proper ICD-10 code to use for a patient undergoing artificial insemination purely for sex preselection?
Posted
Jan 13, 2021
Does the code for intrauterine insemination (IUI) (58322) include the office visit (E/M) for that day, or is that only for the actual procedure?
Posted
Jan 13, 2021
We are inquiring about a coding question for testicular aspirations. What is the consensus for the code used for testicular percutaneous aspirations done in the office?
Posted
Jan 13, 2021
I have a question regarding prewashed sperm and billing for this service. It appears there is a premium being placed on prewashed sperm, but I find nothing in the code definitions for sperm washing or even in the clinical guidelines of each insurance carrier that distinguishes this service as covered.
Posted
Jan 12, 2021
Our physicians do the retrograde semen analysis. What CPT code would you suggest we use?
Posted
Jan 12, 2021
My IVF lab does a full semen analysis with strict morphology. I do a formal interpretation of the results mentioning quality parameters and I also give recommendations, such as: repeat semen analysis, obtain cultures, needs endocrine evaluation, needs IUI, and needs IVF/ICSI. Can I bill for my services? If so, under what CPT code? What would the RVU be?
Posted
Jan 12, 2021
Can you explain the differences between the semen analysis codes?
Posted
Jan 12, 2021
I am seeking clarification of conflicting information we have researched for our practice. Listed below are the two coding corner responses that seem to provide conflicting information regarding CPT code 58323. Our specific question is does 58323 include count and motility analysis? If so, how can that be performed in a lab that does not have CLIA certification? It is my impression that counts can only be performed in a CLIA certified lab.
Posted
Jan 12, 2021
What is the appropriate diagnostic code to use for a semen analysis for the assessment of infertility? Is fertility testing used for males? How about children and adolescence with specific structural problems or testicular failure?
Posted
Jan 12, 2021
What is the CPT code for a semen pellet analysis?
Posted
Jan 12, 2021
We have a couple who are doing an IUI cycle. The husband is expected to be out of town on the day of the insemination, so we've had him come to our office so we can collect and cryopreserve the specimen. We also have to wash the specimen. I know the CPT codes: 89261 and 89259. What would be the best ICD-10 code to use in this situation?
Posted
Jan 12, 2021
What CPT code is applicable for a Semen Leukocyte Analysis or a Reflex Leukocyte Assay?
Posted
Jan 12, 2021
We frequently perform Strict Criteria Morphology alone (without semen analysis). What would be the appropriate code for that test?
Posted
Jan 12, 2021
Is there a CPT code for HALO DNA Fragmentation for sperm? I tried researching and the only code recommended is an unlisted code, CPT 89240. If this is the only code use to report, what CPT code do cross match for pricing?
Posted
Jan 13, 2021
What are the codes for sperm washing when performed in the office vs in a CLIA certified lab?
Posted
Jan 13, 2021
Is it appropriate to bill sperm washing/prep for IUI to the female or should it be billed to the male?
If so, what if there is not a male patient involved?
Posted
Jan 13, 2021
Could we charge for the thaw of sperm, then a handling fee (99000) to represent the fact that the sperm was prewashed or are these services always bundled into 89260/61?
Posted
Jan 13, 2021
What semen analysis codes apply to sperm preparation for IUI or IVF?
Posted
Jan 12, 2021
Is there a separate CPT code for sperm viability?
Posted
Jan 13, 2021
When billing a sperm wash, 58323, to an insurance company we are lucky to receive $10-$20 which is just ridiculous. Does the sperm wash code cover the semen analysis and morphology, or can we bill separately under the male for these services? We bill the sperm wash under the female.
Posted
Jan 13, 2021
What would be the best code to use for a sperm wash when it is not a male factor issue? There is a code for male factor in a female patient, but not a code for a female factor in a male patient. My thought would be to use “Male Infertility-other” (N46.8). Can you please confirm?
