IVF Lab vs Physician Practice Billing
We are planning to open an IVF lab that is not contracted with insurance companies. The stimulation portion of the IVF cycle will be rendered by the physician’s practice which is contracted with insurance. The retrieval, transfer, embryo culture, etc., will be provided by the IVF lab, those services will be paid by the patient, and the patient will seek reimbursement from her insurance if she has coverage. The same physician that monitors the ovulation induction portion of the cycle will be doing the retrievals and transfers in the lab. Is it appropriate to bill the physician's fees for the retrieval (58970) and transfer (58974) under the IVF lab since that is where the service will be provided? Or should those fees be billed under the physician's practice?
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
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.
Shipping of frozen embryos
I have some infertility coverage, under which my insurance said they will cover frozen embryo shipping/transport from one facility to another.
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?
Exclusion of IVF services due to Z31.83
My wife and I have been seeking IVF treatment and this year coverage was added to my benefits for infertility treatment (up to $25,000).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 in vitro fertilization (IVF)
Alabama Supreme Court Rules Frozen Embryos are “Unborn Children” and admonishes IVF’s “Wild West” treatment
Legally Speaking™ on presenting facts and reflecting on the impact and potential implications of legal developments in ART. View the Column
Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline (2023)
Ovarian hyperstimulation syndrome is a serious complication associatedwith assisted reproductive technology. View the guideline
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
Journal Club Global: IVM in Clinical Practice: An Idea Whose Time Has Come?
In vitro maturation (IVM) has the potential to make IVF cheaper, safer, and more widely accessible to patients with infertility. View the Video
Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF: a guideline (2018)
Mild-stimulation protocols with in vitro fertilization (IVF) generally aim to use less medication than conventional IVF. View the Guideline
Limited ultrasound performed by RN
Would it be appropriate to bill a 99211 when an RN is doing a limited ultrasound and documenting findings during an IUI or IVF treatment cycle? View the Answer
CPT 89253 and 89254 for Assisted hatching
Can I bill CPT codes 89253 and 89254 together? If yes, do I need a modifier on any of the codes? View the Answer
IVF cycle management and facility fees, an overview
How should IVF Cycle Management be coded? View the Answer
Journal Club Global - What is the optimal number of oocytes to reach a live-birth following IVF?
The optimal number of oocytes necessary to expect a live birth following in vitro fertilization remains unclear. View the Video
Patient Education
What is the correct way to bill for the patient education sessions performed by registered nurses to individual patients prior to their IVF cycle? 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
IV Fluids During Egg Retrieval
Is it appropriate to bill the insurance company for CPT 96360, Under Hydration Infusion when being used in conjunction with IVF retrieval? View the Answer
IVF Billing Forms
I am seeking information on IVF insurance billing guidelines. View the Answer
IVF Billing Globally
Am I correct in assuming that it is duplicate billing for both the ambulatory center and embryology laboratory to bill globally? View the Answer
IVF Billing of Professional Charges
Are we allowed to bill professional charges under the physician for the embryologist who performs the IVF laboratory services? View the Answer
IVF Case Rates
What ICD-10 codes apply to case rates? View the Answer
In Vitro Maturation
Have CPT codes been established for maturation in vitro? 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
IVF Consent Counseling
When a patient is scheduled to undergo IVF and the provider schedules the patient for a 30-minute consultation is this visit billable? View the Answer
Lab Case Rates
What ICD-10 codes apply to case rates? View the Answer
Oocyte Denudation
Is there is a separate code for denudation of oocytes? View the Answer
Ovulation Induction Monitoring for IUI
We would like to clarify the correct ICD 10 diagnosis code for monitoring of an IUI cycle. View the Answer
Endometrial Biopsy/Scratch
What CPT code should be used for a “scratch test”? View the Answer
Endometriosis and Infertility
For treatment like IVF would we bill with N97.x first or an endometriosis diagnosis? View the Answer
Follicle Monitoring For Diminished Ovarian Reserve
If a patient has decreased ovarian reserve (ICD-10 E28.8) and patient is undergoing follicle tracking to undergo either an IUI cycle or IVF cycle... View the Answer
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
Diagnosis of Infertility for IVF Procedure
How important is it to have accurate documentation of the type of infertility diagnosis for IVF procedures? 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
Egg Culture and Fertilization
We are billing for the technical component of 89250 and would like to also bill a professional component of the 89250. 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 fertilized from male #2. View the Answer
Journal Club Global: Natural versus Programmed FET Cycles
A significant portion of IVF cycles now utilize frozen embryo transfer.
View the Video
Role of assisted hatching in in vitro fertilization: a guideline (2022)
There is moderate evidence that assisted hatching does not significantly improve live birth rates in fresh assisted reproductive technology cycles 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
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
Journal Club Global Live from India - Adjuvants in IVF and IVF Add-Ons for the Endometrium
Many adjuvants have been utilized by IVF centers to improve their success rates. View the Video
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
Development of an emergency plan for in vitro fertilization programs: a committee opinion (2021)
All IVF programs and clinics should have a plan to protect fresh and cryopreserved human specimens (embryos, oocytes, sperm). View the Committee Opinion
In vitro maturation: a committee opinion (2021)
The results of in vitro maturation (IVM) investigations suggest the potential for wider clinical application. 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
Blastocyst culture and transfer in clinically assisted reproduction: a committee opinion (2018)
The purposes of this document is to review the literature regarding the clinical application of blastocyst transfer. View the Committee Opinion
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
Performing the embryo transfer: a guideline (2017)
A systematic review of the literature was conducted which examined each of the major steps of embryo transfer. Recommendations made for improving pregnancy rates are based on interventions demonstrated to be either beneficial or not beneficial. (Fertil Steril® 2017;107:882–96. ©2017 by American Society for Reproductive Medicine.) View the Committee Guideline
Financial ‘‘risk-sharing’’ or refund programs in assisted reproduction: an Ethics Committee opinion (2016)
Financial ‘‘risk-sharing’’ fee structures in assisted reproduction programs charge patients a higher initial fee but provide reduced fees for subsequent cycles and often a partial or complete refund if treatment fails. View the 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 Guideline
What support for IVF looks like
Bipartisan support for IVF, that is responsible for the birth of over 2% of all babies born in the USA each year, will ensure that families continue to grow. View the advocacy resource
It takes more than one
Why IVF patients often need multiple embryos to have a baby View the advocacy resource
In Vitro Maturation Special Interest Group (IVMSIG)
IVMSIG strives to define the best strategies to optimize IVM outcomes. Learn more about IVMSIG
Advocacy Resources
ASRM has prepared resources to help explain and advocate for reproductive rights and the continuation of in vitro fertilization and other fertility treatments. View the advocacy resourcesTopic Resources
View more on the topic of embryo transfer
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
Journal Club Global: Transferencia de embriones frescos versus congelados: ¿Cuál es la mejor opción
Los resultados de nuevas técnicas de investigación clínica que utilizan información de bancos nacionales de vigilancia médica. View the Video
CPT 89253 and 89254 for Assisted hatching
Can I bill CPT codes 89253 and 89254 together? If yes, do I need a modifier on any of the codes? View the Answer
US Embryo Transfer
At the meeting, we learned about the CPT code 76705-Ultasound guidance for embryo transfer, can this code be billed with CPT code 76942? View the Answer
US Embryo Transfer in Surgery Center
Can we use code 76998 for the ultrasound guidance as this patient is being seen in the Surgery Center? View the Answer
US Embryo Transfer-Transmyometrial
How would you code for an ultrasound- guided transvaginal-transmyometrial test transfer of embryo catheter? View the Answer
Uterine Sounding
Is there any specific CPT code(s) for uterine sounding? (Referring to cannulating the cervix and “sounding” or measuring the uterine height) View the Answer
Trial Transfer
Can you advise the proper coding process for a trial transfer? 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
IVF Case Rates
What ICD-10 codes apply to case rates? View the Answer
In Vitro Maturation
Have CPT codes been established for maturation in vitro? View the Answer
IVF Lab vs Physician Practice Billing
We are planning to open an IVF lab that is not contracted with insurance companies. View the Answer
Embryo Thawing/Warming
Is it allowable to bill 89250 for the culture of embryos after thaw for a frozen embryo transfer (FET) cycle? View the Answer
Endometrial Biopsy/Scratch
What CPT code should be used for a “scratch test”? 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
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
Embryo Transfer
A summary of Embryo Transfer codes collected by the ASRM Coding Committee View the Coding Summary
Journal Club Global Live from PCRS - Non-Invasive Embryo Selection Techniques
The next great frontier in reproductive medicine is how to non-invasively select an embryo with the highest reproductive potential for transfer. View the Video
Journal Club Global - Should Fellows Perform Live Embryo Transfers in Fellowship?
Few things are more taboo in reproductive medicine fellowship training than allowing fellows to perform live embryo transfers. View the Video
Journal Club Global Live from ASRM - Optimal Management of the Frozen Embryo Transfer Cycle: Insights From Recent Literature
Three recent papers published in the Fertility and Sterility family of journals, all explore different aspects of optimizing frozen embryo transfer cycles. 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
Compassionate transfer: patient requests for embryo transfer for nonreproductive purposes (2020)
A patient request to transfer embryos into her body in a location or at a time when pregnancy is highly unlikely ... View the Committee Opinion
Blastocyst culture and transfer in clinically assisted reproduction: a committee opinion (2018)
The purposes of this document is to review the literature regarding the clinical application of blastocyst transfer. View the Committee Opinion
Transferring embryos with genetic anomalies detected in preimplantation testing: an Ethics Committee Opinion (2018)
Patient requests for transfer of embryos with genetic anomalies linked to serious health-affecting disorders detected in preimplantation testing are rare but do exist. View the Committee Document
Performing the embryo transfer: a guideline (2017)
A systematic review of the literature was conducted which examined each of the major steps of embryo transfer. Recommendations made for improving pregnancy rates are based on interventions demonstrated to be either beneficial or not beneficial. (Fertil Steril® 2017;107:882–96. ©2017 by American Society for Reproductive Medicine.) View the Committee Guideline
ASRM standard embryo transfer protocol template: a committee opinion (2017)
Standardization improves performance and safety of embryo transfer View the Committee OpinionTopic Resources
View more on the topic of ovarian stimulation
Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline (2023)
Ovarian hyperstimulation syndrome is a serious complication associatedwith assisted reproductive technology. View the guideline
Comparison of pregnancy rates for poor responders using IVF with mild ovarian stimulation versus conventional IVF: a guideline (2018)
Mild-stimulation protocols with in vitro fertilization (IVF) generally aim to use less medication than conventional IVF. View the Guideline
Ultrasound for Ovarian Cyst
When a patient has a cyst from a previous Clomid or gonadotropin cycle, is it appropriate to bill the insurance company for the ultrasound with a N83.x? View the Answer
Coding of transabdominal vs. transvaginal ultrasound
I recently was informed that CPT 76857 can be used for a transvaginal ultrasound when done for a follicle check by a fertility practice. View the Answer
IVF Consent Counseling
When a patient is scheduled to undergo IVF and the provider schedules the patient for a 30-minute consultation is this visit billable? View the Answer
Oocyte Aspiration
Should one bill oocyte aspiration as a bilateral procedure? View the Answer
Journal Club Global: Management of poor ovarian response
A poor ovarian response to what should otherwise be a successful stimulation cycle presents a clinical conundrum for clinicians. 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
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 Guideline
Executive summary of the Stages of Reproductive Aging WorkshopD10: addressing the unfinished agenda of staging reproductive aging (2012)
The aim of this article is to summarize the recommended updates to the 2001 Stages of Reproductive Aging Workshop (STRAW) criteria. View the Committee Guideline
Abdominal Paracentesis
We do a lot of abdominal paracenteses on patients at our facility. View the answerTopic Resources
View more on the topic of ovulation induction
Ultrasound Images
During ultrasound for follicle checks, does an image need to be saved to a chart? 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
IVF Case Rates
What ICD-10 codes apply to case rates? View the Answer
Ovulation Induction Monitoring for IUI
We would like to clarify the correct ICD 10 diagnosis code for monitoring of an IUI cycle. View the Answer
Ovulation Induction Monitoring With PCOS
We have a patient insisting that we code the ultrasound follicle monitoring with the PCOS diagnosis. View the Answer
Coding for Ovarian Drilling
Can you provide some information related to ovarian drilling that would assist non-physician administration (coders, billers)? View the Answer
