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Pathology/Lab Coding Alert

Try Coding This IVF Scenario

Published on Mon Sep 27, 2004

Then check your answers against the experts

Try your hand at coding the following case, which represents a possible course of treatment for a couple undergoing in-vitro fertilization (IVF), according to Jeffrey P. Boldt, PhD, program and scientific director of Assisted Fertility Services in Indianapolis. Remember to capture each procedure the lab performs.

Example: After physician retrieval services, lab personnel identify eight oocytes from follicular fluid and gradient-wash sperm in preparation for insemination. Due to low sperm count, the lab performs intracytoplasmic sperm injection for the eight oocytes. The lab cultures the embryos for three days. Based on family history, lab personnel screen the embryos for genetic disorders. On the fourth day since egg retrieval (day zero), lab personnel freeze six embryos and prepare two for transfer.

Does Your Coding Match the Experts'?

Now that you've tried your hand at coding the scenario, check your codes against those provided by our experts.

Identification of oocytes retrieved by physician:
 

  • CPT 89254 - Oocyte identification from follicular fluid.

    "Regardless of the number of oocytes identified, report one unit of 89254," says Melanie Witt, RN, CPC, MA, an independent coding educator based in Fredericksburg, Va.

    Gradient-wash sperm:
     
  • 89261 - Sperm isolation; complex prep (e.g., Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis.

    ICSI fertilization: 
     
  • 89280 - Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes.

    Embryo culture:
     
  • 89250 - Culture of oocyte(s)/embryo(s), less than 4 days.

    Genetic diagnosis:
     
  • 89291 - Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5 embryos.

    Transfer preparation:
     
  • 89255 - Preparation of embryo for transfer (any method).

    Freezing remaining embryos:
     
  • 89258 - Cryopreservation; embryo(s).

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