IUI using donor sperm d/t transgender partner

HCundiff

Networker
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Casper,WY
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I am at a complete loss. My OB/GYNs do some fertility work such as follicle checks for planned intercourse and inseminations. A few patients in the past were in lesbian relationships and used donor semen to concieve. In these situations, there has benn an exacerbating condition in the partner being inseminated. Therefore, I used that as the diagnosis.

Currently, we are seeing a patient that has no female genitourinary conditions that would cause an issue with fertility. Her partner is a Transgender male. Therefore, they will be using donor sperm for the IUI. I don't know what diagnosis code I should use. The patient believes she does have insurance coverage for this service. I gave her the CPT codes to call insurance to verify coverage but don't know what ICD-10 to pass along. I fear that may play a factor in if the service is covered or not.

Anyone have any ideas? I appreciate any assistance. Even if it's just an idea of where to go to reasearch the matter more.

Thank you!
 

OpenClaims

Expert
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Location
Miami, FL
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I think that this is pretty patient specific. I am not help with diagnoses for this unfortunately, but I'd suggest calling their insurance company and talking to them yourself to explain the scenario in a way that coders and billers understand.
 
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