CPT has created the "Reproductive Medicine Procedures" section in the manual to clearly mark new technologies and changing medical practice in reproductive medicine, says Terry Tropin, RHIA, CPC, CCS-P, manager of coding education for the American College of Obstetricians and Gynecologists (ACOG). Codes 89350-89399 have been renumbered and placed under the category heading "Other Procedures." CPT groups the new section's procedures by type:
Oocyte/embryo culture and fertilization techniques (89250, 89251, 89268, 89272, 89280 and 89281)
Oocyte/embryo biopsy techniques (89290 and 89291)
Freezing, thawing and storage techniques (89258, 89259, 89335, 89342, 89343, 89344, 89346, 89352, 89353, 89354 and 89356). These are nonphysician procedures that highly specialized clinical laboratories perform, Tropin says. If a physician provides services at the same time, you may report them also.
"These new and revised codes will assist us to code more specifically for services rendered, as well as facilitate negotiations with our payers," says Marie Mulhall, LPN, CPC, director of coding at Women's Health Connecticut in Avon.
When creating this new section, CPT deleted 89252 (Assisted oocyte fertilization, microtechnique [any method]) and 89256 (Preparation of cryopreserved embryos for transfer [includes thaw]) and renumbered them to 89280/89281 or 89352, respectively.
In addition, CPT 2004 includes two new Category III codes (0058T, Cryopreservation of reproductive tissue, ovarian; and 0059T, Cryopreservation of oocyte[s]) for tissue and oocyte cryopreservation procedures. If the ob-gyn performs a procedure that matches one of the new Category III codes, you should report it, rather than an unlisted-service code.
The other new and revised codes are as follows:
89250 - Culture of oocyte(s)/embryo(s), less than 4 days
89251 - ... with co-culture of oocyte(s)/embryos
Note: Code 89250 now allows you to report the culture of immature oocytes. Fertilization is no longer part of this code, and you should report it separately. You should also separately submit insemination, which was considered part of 89250 in CPT 2003. Code 89251 represents the additional work of microfertilization of more than 10 oocytes.
89258 - Cryopreservation; embryo(s)
89268 - Insemination of oocytes
89272 - Extended culture of oocyte(s)/embryo(s), 4-7 days
Note: You can bill 89272 with 89250 and 89251 because it represents a separate technique.
89280 - Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes
89281 - ... greater than 10 oocytes
89290 - Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or equal to 5 embryos
89291 - ... greater than 5 embryos
89335 - Cryopreservation, reproductive tissue, testicular
89342 - Storage, (per year); embryo(s)
89343 - ... sperm/semen
89344 - ... reproductive tissue, testicular/ovarian
89346 - ... oocyte
89352 - Thawing of cryopreserved; [...]