COVID-19 Resources

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

EMR Shared Phrases/Template Library

View the Shared Phrases/Template Library

ASRM MAC Tool 2021

View the MAC Tool

QBoost

Level up your knowledge of ASRM’s committee documents by using spaced learning to retain information longer. Sign Up for QBoost soon!

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. Code for the following: • A single female using donor IUI, or a lesbian couple using donor IUI • A transgender female coming to bank sperm before transitioning • A young professional women coming to bank eggs for social reasons 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. Recently, we are receiving insurance denials. No other diagnosis codes can be used, i.e., maternal complications, etc., in most of these cases. The sac check is done routinely before we transfer the patient to their OB/GYN. Do you have any billing tips for the follow-up sac checks? 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? There is no established code for this. Should a 52 modifier be used if all the complete ultrasound measurements are not taken? What about a limited follow up transvaginal ultrasound? View the Answer

Limited Transvaginal Ultrasound

One of our clients received information from your website that a repeat limited transvaginal ultrasound should be billed with a limited pelvic ultrasound code (76857). I am wondering if someone could verify that this information is accurate and let us know what that guidance is based upon. The American College of Radiology differentiates the two types of studies in the 2006 Ultrasound Coding User’s Guide. “The pelvic ultrasound using a full bladder as a window to the pelvis and a transvaginal ultrasound using a vaginal probe as a window to the pelvis are separately coded procedures. A common practice is for ultrasound departments to begin with a pelvic ultrasound performed through a full bladder and to supplement the examination with a transvaginal ultrasound. When the transvaginal examination is used as the only technique, use 76830 for the procedure.” 76830 Ultrasound, transvaginal 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 76857 Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (e.g., for follicles) 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. Nursing staff meets with the patient after ultrasounds are performed and blood work is drawn. Ultrasound results are discussed with the patient at that time. All results are discussed with the physician who is in the office. The nursing staff contacts the patient later in the afternoon after the blood work results are complete. Is this an appropriate use of this E+M code? Can we submit team-management CPT codes per patient for daily cycle-management conferences that determine ongoing treatment during the cycle? Do those codes require more significant amounts of time spent than the few minutes per patient that are spent? 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. She is thinking about bringing an Ob-Gyn on board to assist. In anyone's experience, is it common for an MD to perform REI procedures if not their specialty? If the billing is the same, is it allowable for the non-REI to submit for REI procedures? I understand the credentials make the CPTs valid but in general, is this allowable? Thank you! 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. 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? View the Answer

Flat Fee For Outside Monitoring

Can our office charge outside monitoring patients a flat fee to be seen? The patients are under the care of another physician, but we are performing an ultrasound and bloodwork. Do we have to bill the insurance if they are coming to our office even though they are not being treated by our doctors? 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 has a private office with no access to an embryology/andrology lab but does use an outside facility to perform the retrievals and transfers. The facility is not billing insurance for the lab services. Would my physician be able to bill for professional and lab services under his NPI and tax ID if ALL services are being performed at this outside clinic? 
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? Specifically, could an ob-gyn submit for 58970 the same as an REI? I know with PAs/NPs there are certain modifiers which reflect less receivables for their education.  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. Would you bill that in addition to the egg retrieval procedure and bill as unlisted? Here is an example of how it is documented. Thank you for your help! “2-0 Vicryl stitch placed on anterior lip of cervix and cervix dilated with Pratt dilators. Speculum was removed.” 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? For example, AH on day three, embryo biopsy on day 5/6 during blast stage. Or, does the embryo biopsy essentially take the place of AH when performed? View the Answer

ASRM Applauds the Introduction of the Family Building FEHB Fairness Act

ASRM is thrilled by today’s introduction of the Family Building FEHB Fairness Act of 2023 by Representatives Gerry Connolly (D-VA) and Nancy Mace (R-SC). View the Press Release

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 by the ASRM Coding Committee, for a fresh ART cycle, transfer, biopsy, cryopreservation of embryos and oocytes, storage, and thawing. View the Coding Summary

Egg Freezing Cycles jumped 31% in 2021

89,208 Babies were Born using Assisted Reproductive Technology According to the Latest SART data View the Press Release

ASRM Applauds OPM’s Updated Health Benefits for Federal Employees with Expanded ART Coverage

The American Society for Reproductive Medicine (ASRM), which has long advocated for fertility coverage, is thrilled to share that the U.S. Office of Personnel Management’s (OPM) Federal Employees Health Benefits (FEHB) program includes in its 2024 carrier letter a call for plans to include artificial insemination (intrauterine insemination, intracervical insemination, and intravaginal insemination) and associated medication, and medication for up to three cycles of IVF annually. This builds on a fertility preservation benefit added in 2022, also with ASRM support. View the Press Release

ASRM Taskforce on the Needs and Interests of Donor Conceived People and their Families

As the practice of gamete donation has increased steadily in the last 30 years, gamete donation has helped many people to become parents. Because of our prominent role in reproductive medicine, ASRM has great potential to influence practices and policies that promote the well-being of these families we helped to form. View the Bulletin

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

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

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 in vitro fertilization.
View the Committee Opinion

Minimum standards for practices offering assisted reproductive technologies: a committee opinion (2021)

This document is designed to provide a framework for assisted reproductive technology (ART) programs that meet or exceed the requirements suggested by the Centers for Disease Control and Prevention for certification of ART laboratories.  View the Committee Opinion

Journal Club Global - Recurrent Implantation Failures in ART: Myth or Reality?

View the Video

Correct coding for laboratory procedures during assisted reproductive technology cycles

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

Psychological Evaluation

In accordance with ASRM practice guidelines, many REs require patients (and their spouses/partners) who are considering using donor gametes to see an infertility counselor first. Assuming the purpose of these consultations is to explore relevant psychosocial issues, rather than to evaluate "suitability" for treatment, how should they be coded by the infertility counselor? View the Answer

IVF Case Rates

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

Donor Screening

I am emailing on behalf of CCRM/Member is Steve Gerson (12077). Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code? We know the FDA requires a significant screening but cannot find any details on the code to bill for this if and when insurance is involved. 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 of donor eggs be fertilized with sperm from male #2. How should this be billed? Specifically, in our split donor egg cycle for this same-sex male couple, we performed two separate sperm preps, two fertilization procedures (in this case, one was fertilized by ICSI and the other by IVF). We kept the two sets of embryos in separate dishes to culture and monitor extended culture of their embryos under separate case IDs, then we froze each embryo individually and stored each set of embryos created from each of the partners in separate canes. View the Answer

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. Medicare guidelines are being quoted as stating the Z11.3 is not a proper principal diagnosis code. Do you have any suggestions/feedback on an additional/alternate diagnosis code? We are having difficulty finding one that is more appropriate. Thanks so much! 138828 Donor C. Trachomatis/N.Gonorrhoeae; 138930 Donor CMV Total w/Reflex to IgM and IgG; 138699 Donor HBcAb Total; 138749 Donor HBsAg w/Reflex to confirmatory neut. Assay; 138907 Donor HCV Ab; 138931 Donor HIV-1/HIV-2 Plus O w/ Reflex to HIV-1 WB; 138780 Donor HTLV-I/II Ab w/Reflex to Immunoblot; 139240 Donor Procleix Ultrio Assay; 139280 Donor Syphillis (T-Pallidum IgG); 139486 Sperm Donor Viromed Panel. View the Answer

Donor Egg Lot Acquisition

What is the code for egg lot acquisition? In other words, the donor match fee or egg procurement. An agency finds her, does physical and mental screening and charges one lump fee. View the Answer

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? We know the FDA requires a significant screening but cannot find any details on the code to bill for this if and when insurance is involved. View the Answer

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? 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

Claim Form for Donor Egg Retrieval

What bill form is used of IVF donor egg retrieval? View the Answer

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? The egg donor is not the gestational carrier in this case. View the Answer

Updated terminology for gamete and embryo donors: directed (identified) to replace ‘‘known’’ and nonidentified to replace ‘‘anonymous’’: a committee opinion (2022)

The American Society for Reproductive Medicine encourages all stakeholders with an interest in gamete and embryo donation to adopt directed (identified) in lieu of ‘‘known’’ and nonidentified in lieu of ‘‘anonymous’’ to more accurately describe the relationships between donors and recipients in this new era of social media and genetic information sharing. View the Committee Opinion

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 and should acknowledge the time, inconvenience, and discomfort associated with screening, ovarian stimulation, oocyte retrieval, and post-retrieval recovery and not vary according to the planned use of the oocytes or the number or quality of oocytes retrieved. View the Committee Opinion

Gestational Carrier

I would like to confirm ASRM’s opinion on the best code to use for a gestational carrier cycle. The code I have located is Z31.89 (Encounter for other procreative management), but I would appreciate a second opinion. View the Answer

Consideration of the gestational carrier: an Ethics Committee opinion (2023)

Intended parents engage with gestational carriers (GCs) to achieve their personal reproductive goals. View the Committee Opinion

Recommendations for practices using gestational carriers: a committee opinion (2022)

This document provides the latest recommendations for the screening, evaluation, and psychoeducational and legal counseling of gestational carriers and intended parents. View the Committee Opinion

Canadian Class Action Lawsuit for Fertility Fraud Against MD Settled for $13.375m

Stories: Canadian Class Action Lawsuit for Fertility Fraud Against MD Settled for $13.375m; Japanese woman places baby for adoption and sues “sperm donor” after learning of misrepresentations ; Belgium Court Finds Hospital Liable to Family in “Savior Sibling” Embryo Mix-Up; International Surrogacy Updates View the Column

ASRM Today: Mental Health with Dr. Kim Bergman

Today on the show my guest is Kim Bergman, PhD, a licensed psychologist since 1990, who has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for intended parents, surrogates and donors.  Listen to the Episode

Transgender Care

I have a question about a patient who is a transgender male to female. The patient has had sexual reassignment surgery; however, she comes in for medroxyprogesterone acetate (Provera) and spironolactone medication refills as well as injections of estradiol valerate (Delestrogen). We initially had coded it as Z87.890 and, of course, insurance denied it. The patient disputed the denial because she states that she is legally a female now. An addendum was added stating that the patient suffers from intersexuality, endocrine disorder. At that time, per my coding manager, we changed the coding to F64.0. We are questioning if this is the correct way of the order of diagnoses or if you have any other thoughts on how this should be coded. 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

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 of donor eggs be fertilized with sperm from male #2. How should this be billed? Specifically, in our split donor egg cycle for this same-sex male couple, we performed two separate sperm preps, two fertilization procedures (in this case, one was fertilized by ICSI and the other by IVF). We kept the two sets of embryos in separate dishes to culture and monitor extended culture of their embryos under separate case IDs, then we froze each embryo individually and stored each set of embryos created from each of the partners in separate canes. View the Answer

ASRM Announces $100,000 Donation To Establish The “Samuel C. Pang, Md, Leadership In LGBTQ+ Education & Research Fund”

Washington, DC –ASRM is pleased to announce the creation of the “Samuel C. Pang, MD, Leadership in LGBTQ+ Education & Research Fund,” made possible thanks to a $100,000 gift from Andrew Searle Pang and Samuel C. Pang, MD. View the Press Release

Access to fertility treatment irrespective of marital status, sexual orientation, or gender identity: an Ethics Committee opinion (2021)

This statement explores the implications of reproduction by single individuals and unmarried couples and pertains to diverse sexuality and gender (DSG) or cisgender heterosexual persons. The statement concludes that individuals and couples should have access to fertility services irrespective of marital status, sexual orientation, or gender identity. View the Committee Opinion

LBGTQ Special Interest Group (LGBTQSIG)

The LGBTQ Special Interest Group exists to foster an environment of inclusivity for all potential parents to have a voice and an advocate within the ASRM. Learn more about the LGBTQSIG

Gestational Carrier

I would like to confirm ASRM’s opinion on the best code to use for a gestational carrier cycle. The code I have located is Z31.89 (Encounter for other procreative management), but I would appreciate a second opinion. View the Answer

Donor Screening

I am emailing on behalf of CCRM/Member is Steve Gerson (12077). Is there a specific CPT code used for Donor Physical Exams or would a practice just bill using the appropriate E&M Code? We know the FDA requires a significant screening but cannot find any details on the code to bill for this if and when insurance is involved. 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 of donor eggs be fertilized with sperm from male #2. How should this be billed? Specifically, in our split donor egg cycle for this same-sex male couple, we performed two separate sperm preps, two fertilization procedures (in this case, one was fertilized by ICSI and the other by IVF). We kept the two sets of embryos in separate dishes to culture and monitor extended culture of their embryos under separate case IDs, then we froze each embryo individually and stored each set of embryos created from each of the partners in separate canes. View the Answer

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. Medicare guidelines are being quoted as stating the Z11.3 is not a proper principal diagnosis code. Do you have any suggestions/feedback on an additional/alternate diagnosis code? We are having difficulty finding one that is more appropriate. Thanks so much! 138828 Donor C. Trachomatis/N.Gonorrhoeae; 138930 Donor CMV Total w/Reflex to IgM and IgG; 138699 Donor HBcAb Total; 138749 Donor HBsAg w/Reflex to confirmatory neut. Assay; 138907 Donor HCV Ab; 138931 Donor HIV-1/HIV-2 Plus O w/ Reflex to HIV-1 WB; 138780 Donor HTLV-I/II Ab w/Reflex to Immunoblot; 139240 Donor Procleix Ultrio Assay; 139280 Donor Syphillis (T-Pallidum IgG); 139486 Sperm Donor Viromed Panel. View the Answer

Donor Egg Lot Acquisition

What is the code for egg lot acquisition? In other words, the donor match fee or egg procurement. An agency finds her, does physical and mental screening and charges one lump fee. View the Answer

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? We know the FDA requires a significant screening but cannot find any details on the code to bill for this if and when insurance is involved. View the Answer

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? 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

Claim Form for Donor Egg Retrieval

What bill form is used of IVF donor egg retrieval? View the Answer

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? The egg donor is not the gestational carrier in this case. View the Answer