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.
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Coding Q&A
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Coding PGT requisitions to the PGT lab
Do you have any recommended codes to use for PGT requisitions to the PGT lab?
Billing for cryopreservation procedures on different days
I understand that if cryopreservation of oocytes is performed on two separate dates of service, each date of service was billable.
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?
Estradiol Free versus Total
Should patients with fertility issues be billing Estradiol Free (82681) instead of Estradiol Total (82670)?Coding Corner
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Coding Corner Q & A
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COVID-19 Resources
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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.
Topic Resources
View more on the topic of egg donation
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
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
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
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
Many REs require patients (and their spouses/partners) who are considering using donor gametes to see an infertility counselor first. View the Answer
IVF Case Rates
What ICD-10 codes apply to case rates? View the Answer
Diagnosis Code For Same-Sex Egg Donation
We have a same-sex male couple with insurance coverage for IVF. 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. View the Answer
Donor Egg Lot Acquisition
What is the code for egg lot acquisition? 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? 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? 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
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
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
Claim Form for Donor Egg Retrieval
What bill form is used of IVF donor egg retrieval? View the Answer
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
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
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
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
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
Using family members as gamete donors or gestational carriers (2017)
The use of adult intrafamilial gamete donors and gestational surrogates is generally ethically acceptable when all participants are fully informed. View the Committee Document
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 OpinionTopic 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
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 intracytoplasmic sperm injection (ICSI)
ICSI and Embryo Biopsy
How to bill for ICSI or embryo biopsies that occur in different days? View the Answer
Oocyte Denudation
Is there is a separate code for denudation of oocytes? View the Answer
Denudation of Oocytes
Is there is a separate code for denudation of oocytes? And if denuding oocytes is bundled into another code for either IVF or ICSI, please explain. View the Answer
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 DocumentTopic Resources
View more on LGBTQIA+ issues
What's New from the Fertility and Sterility Family of Journals
Here’s a peek at this month’s issues from our family of journals! As an ASRM Member, you can access all of our journals. Not yet a member? Click here(no link) to learn more. Find More
Transgender Care
I have a question about a patient who is a transgender male to female. 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
Diagnosis Code For Same-Sex Egg Donation
We have a same-sex male couple with insurance coverage for IVF. View the Answer
Access to fertility treatment irrespective of marital status, sexual orientation, or gender identity: an Ethics Committee opinion (2021)
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
Access to fertility services by transgender and nonbinary persons: an Ethics Committee opinion (2021)
The provision of fertility services to transgender individuals and the denial of access to fertility services is not justified. 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 LGBTQSIGTopic Resources
View more on the topic of third-party reproduction
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
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
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
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
Gestational Carrier
I would like to confirm ASRM’s opinion on the best code to use for a gestational carrier cycle. View the Answer
Diagnosis Code For Same-Sex Egg Donation
We have a same-sex male couple with insurance coverage for IVF. 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. View the Answer
Donor Egg Lot Acquisition
What is the code for egg lot acquisition? 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? 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? 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
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
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
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? View the Answer
