2025 CPT code 89268
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Laboratory - Reproductive Medicine Procedures Pathology and Laboratory Procedures Feed
Insemination of oocytes during in vitro fertilization (IVF).
Modifiers may be applicable depending on the circumstances of service.Consult the current CPT guidelines for appropriate modifier usage.
Medical necessity for code 89268 is established by the patient's diagnosis of infertility and the physician's determination that IVF is the appropriate treatment. Documentation supporting the infertility diagnosis and medical necessity for IVF treatment should be included.The specific requirement varies with the payer.
The clinical responsibility lies with the laboratory analyst who performs the technical aspects of insemination. The ordering physician is responsible for the overall patient care and interpretation of results within the context of the IVF cycle.
In simple words: This lab test involves carefully combining sperm and eggs in a dish to help with fertilization during IVF (in vitro fertilization) treatment. This is a step in helping a couple conceive a baby.
This CPT code, 89268, represents the laboratory procedure of inseminating oocytes retrieved from a female patient during an in vitro fertilization (IVF) cycle.The procedure involves the technical steps of introducing isolated sperm to the oocytes in a culture dish to facilitate fertilization for conception and pregnancy.This service is typically ordered in facilities specializing in reproductive medicine and infertility treatments.
Example 1: A patient undergoes IVF treatment.The embryologist performs oocyte insemination using the standard IVF technique. Code 89268 is reported for this laboratory service., A patient presents for intracytoplasmic sperm injection (ICSI).While ICSI is a separate procedure, insemination of oocytes may still be part of the overall process.Code 89268 might be reported if the insemination step is distinct and separately performed., In cases of donor egg insemination, the laboratory analyst would still perform the insemination process. Code 89268 is appropriate for reporting this service, irrespective of whether the eggs are from the patient or a donor.
* Patient demographics and identifying information*Physician's order specifying the need for oocyte insemination* Date and time of the procedure* Number of oocytes inseminated*Details of the sperm preparation and handling*Method of insemination*Documentation confirming the successful insemination.
** Always refer to the most current CPT manual and payer-specific guidelines for accurate coding and reimbursement.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: This information is not available in the provided source.Consult the current CPT codebook or a medical billing resource for RVU values.
- Global Days: This is a laboratory procedure; global surgical days are not applicable.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this laboratory procedure.
- Fee Schedule: This information requires a consultation of historical fee schedule data,This is not included in provided sources.
- Specialties:Reproductive Endocrinology and Infertility, Obstetrics and Gynecology, Pathology
- Place of Service:Laboratory, Ambulatory Surgical Center