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.
ASRM Billing Guidance by Procedure
Each page below translates ASRM's published CPT guidance into actionable billing reference for fertility practices.
IVF Billing
ASRM CPT guidance for oocyte retrieval, embryo culture, fresh transfer, and freeze-all cycles.
View billing guide →IUI Billing
Code selection for intrauterine insemination, sperm processing, and monitoring — aligned with ASRM recommendations.
View billing guide →FET Billing
Frozen embryo transfer billing: thaw codes, transfer codes, and endometrial preparation monitoring.
View billing guide →ICSI Billing
Coding for intracytoplasmic sperm injection — 89280 vs. 89281, documentation requirements, and bundling rules.
View billing guide →Egg Freezing
Elective and oncofertility oocyte cryopreservation billing, following ASRM guidance on coverage classification.
View billing guide →PGT Billing
Embryo biopsy codes, genetics lab coordination, and the billing chain from biopsy through FET.
View billing guide →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.
| Procedure | ASRM Guidance | CPT Code(s) | EasyRCM Billing Note |
|---|---|---|---|
| Oocyte Retrieval | Follicle aspiration as a distinct surgical event | 58970 | Bill once per retrieval encounter regardless of egg count. Do not add 76948 unless payer allows separate imaging billing. |
| Fresh Embryo Transfer | Transfer of non-cryopreserved embryos in the same cycle | 58974 | Use only for fresh transfers in the same stimulation cycle. FET cycles require 58976 — the most common transfer coding error. |
| Frozen Embryo Transfer | Standalone FET cycle using previously cryopreserved embryos | 58976 | Bill with 89352 (embryo thaw) on the thaw date. 58976 is separately authorized from the original retrieval cycle. |
| ICSI | Intracytoplasmic sperm injection by oocyte count | 89280 / 89281 | 89280 for ≤10 oocytes; 89281 for >10. Bill one code per session — do not bill both for the same retrieval. |
| PGT Embryo Biopsy | Trophectoderm biopsy for PGT-A, PGT-M, or PGT-SR | 89290 / 89291 | 89290 for <5 embryos biopsied; 89291 for ≥5. Separate from the genetics lab codes (81228, 81229, 81479) billed by the PGT lab. |
| Oocyte Cryopreservation | Egg freezing — elective or oncofertility | 89337 | Following ASRM removal of the experimental designation, coverage has expanded. ICD-10 must reflect elective (Z31.84) or medical (Z79.890 + oncology dx) indication. |
| Embryo Cryopreservation | Freezing of embryo(s) after IVF or ICSI | 89258 | Bill 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 transfer | 89352 | Bill 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?
Our free audit reviews a sample of your ART claims and identifies coding gaps, bundling errors, and opportunities to align with ASRM CPT recommendations.
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