ASRM Billing Reference

ASRM Billing Guidelines —
Translated for Fertility Billers

The American Society for Reproductive Medicine (ASRM) publishes CPT code recommendations and clinical guidance for ART procedures through its Practice Committee and ART CPT Committee. EasyRCM aligns billing practices with ASRM's published CPT recommendations for ART procedures — translating that clinical guidance into the specific codes, documentation requirements, and payer-specific rules that fertility billing teams need to submit clean claims and win denials.

Key ASRM CPT Guidance Areas

Representative code examples only. Correct code selection depends on clinical documentation, payer contract terms, and the specific clinical scenario. ASRM guidance informs CPT selection — final billing decisions require review against payer policy.

ProcedureASRM GuidanceCPT Code(s)EasyRCM Billing Note
Oocyte RetrievalFollicle aspiration as a distinct surgical event58970Bill once per retrieval encounter regardless of egg count. Do not add 76948 unless payer allows separate imaging billing.
Fresh Embryo TransferTransfer of non-cryopreserved embryos in the same cycle58974Use only for fresh transfers in the same stimulation cycle. FET cycles require 58976 — the most common transfer coding error.
Frozen Embryo TransferStandalone FET cycle using previously cryopreserved embryos58976Bill with 89352 (embryo thaw) on the thaw date. 58976 is separately authorized from the original retrieval cycle.
ICSIIntracytoplasmic sperm injection by oocyte count89280 / 8928189280 for ≤10 oocytes; 89281 for >10. Bill one code per session — do not bill both for the same retrieval.
PGT Embryo BiopsyTrophectoderm biopsy for PGT-A, PGT-M, or PGT-SR89290 / 8929189290 for <5 embryos biopsied; 89291 for ≥5. Separate from the genetics lab codes (81228, 81229, 81479) billed by the PGT lab.
Oocyte CryopreservationEgg freezing — elective or oncofertility89337Following ASRM removal of the experimental designation, coverage has expanded. ICD-10 must reflect elective (Z31.84) or medical (Z79.890 + oncology dx) indication.
Embryo CryopreservationFreezing of embryo(s) after IVF or ICSI89258Bill once per freeze session. Annual storage (89346) is a separate, typically self-pay service. Some mandate payers cover the freeze; almost none cover ongoing storage.
Embryo Thaw (FET)Thawing of cryopreserved embryos for transfer89352Bill on the date of thaw, separately from the transfer procedure (58976). Authorization for the FET cycle must cover both codes.

What ASRM Publishes — and What It Doesn't

ASRM's Practice Committee and ART CPT Committee produce evidence-based guidance on which CPT codes apply to ART procedures and submit CPT revision requests to the AMA when existing codes don't adequately represent current practice. This guidance is authoritative within the reproductive medicine specialty and is widely referenced by payers when developing coverage policies.

What ASRM guidance does not provide is the billing practitioner layer: which payers bundle which codes, how to sequence diagnosis codes to satisfy authorization matching, what documentation is required to survive a medical necessity audit, or how to appeal a denial when a payer's internal policy conflicts with ASRM-endorsed coding. That translation is what fertility billing specialists do.

EasyRCM's coding team maintains current reference to ASRM's published CPT guidance and incorporates it into payer-specific billing workflows for every ART procedure type. When ASRM guidance and payer policy conflict — which happens regularly — we document the conflict, appeal with ASRM guidance as supporting authority, and track outcomes by payer.

Is your practice billing in line with ASRM guidance?

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