Pathology/Lab Coding Alert

Select the correct code from each of the 6 steps

Assisted reproductive technology (ART) is becoming more complicated, but the coding just keeps getting easier. With the addition of the "Reproductive Medicine Procedures" section to pathology and laboratory codes in CPT Codes 2004, labs that perform the multiple steps involved in ART now have a host of specific codes to describe their services.

Technical Codes Describe ART Steps A physician treating a couple for infertility may generate multiple laboratory encounters over months of treatment. "ART requires several sequential steps over a period of time that often involve technical lab procedures for manipulating reproduction," says Melanie Witt, RN, CPC, MA, an independent coding educator based in Fredericksburg, Va.

The process begins with physician services to retrieve eggs and/or collect sperm, and then typically involves some of the following six steps before concluding with physician transfer services.

1. Egg/sperm identification

2. Fertilization/Insemination

3. Culturing

4. Preservation/Storage

5. Genetic Diagnosis

6. Preparation for transfer (includes thawing and hatching, if done). Before the addition and revision of more than 15 codes in CPT 2004, the handful of reproductive medicine lab codes inadequately described some commonly performed ART lab services. "The revised coding has been very beneficial in billing our lab services, allowing us to more accurately report the multitude of steps we perform, and enhancing insurance reimbursement for these services," says Jeffrey P. Boldt, PhD, program and scientific director of Assisted Fertility Services in Indianapolis. Use New Codes for Specific ART Treatments Study the chart on page 85 to see how to use the existing, new, and revised reproductive medicine codes to report each part of the ART lab procedure. The table shows codes arranged by the six possible lab steps involved in ART rather than listing the codes in numerical order. The table does not include semen analysis codes (89300-89330).