S Codes — Mandate Payers
S4013
Three or More Oocytes Retrieved — IVF
Complete IVF cycle, with 3 or more oocytes retrieved, but not meeting criteria for complete S4011 cycle. Used by mandate payers for tracking partial cycle counts where fewer embryos resulted from retrieval.
Billing Notes
S4013 is used when at least 3 oocytes were retrieved but the cycle did not result in embryo transfer. Document the oocyte count precisely in the procedure note. Select carefully between S4011, S4013, S4014, and S4016 based on cycle outcome.
Diagnosis Codes
N97.x (infertility), Z31.61 (ART encounter)
Common Denial Reasons
- S4011 submitted when fewer than expected oocytes were retrieved
- Cycle outcome documentation does not match S code submitted
- Payer does not require this S code
Payer Notes
S code selection depends on the payer's specific requirements and cycle outcome. Always reference the payer's S code billing guidelines before submitting.
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