2025 CPT code 89320
(Active) Effective Date: N/A Laboratory - Reproductive Medicine Procedures Pathology and Laboratory Feed
Semen analysis; volume, count, motility, and differential.
Modifiers may be applicable. Modifier 90 is used if the specimen is sent to an outside laboratory, modifier 91 is used for repeat laboratory tests, and modifier 52 may be used if the physician performs only part of the semen analysis.
Medical necessity for 89320 is established when the test is performed to evaluate male infertility or to assess the success of a vasectomy.Documentation supporting the medical necessity should be present in the patient's record.
The laboratory analyst performs the technical aspects of the semen analysis. The clinician orders the test and interprets the results to evaluate male fertility or vasectomy success.
In simple words: This test analyzes a semen sample to check a man's sperm health. It measures the amount of semen, the number of sperm, how well they move, and their shape.It helps determine if a man has fertility problems or if a vasectomy was successful.
This code represents a comprehensive semen analysis evaluating various parameters crucial for assessing male fertility. The analysis includes determining the semen volume, sperm count (concentration), sperm motility (the ability of sperm to move effectively), and sperm differential (morphology), which examines the size and shape of the sperm.This test helps evaluate male infertility by assessing factors such as low sperm count, poor sperm movement, or abnormalities in sperm structure. It can also be used to assess the effectiveness of a vasectomy.
Example 1: A 35-year-old male and his partner have been trying to conceive for a year without success. The physician orders a semen analysis (89320) to assess the patient's sperm health and identify any potential factors contributing to infertility., A 50-year-old male recently underwent a vasectomy.A semen analysis (89320) is performed two months post-procedure to confirm its effectiveness and ensure the absence of sperm in the ejaculate., A 25-year-old male with a history of testicular trauma presents with concerns about his fertility.A semen analysis (89320) is ordered to evaluate the impact of the injury on sperm production and function.
Documentation should include the reason for the semen analysis (e.g., infertility evaluation, post-vasectomy confirmation), the date of the specimen collection, and any relevant patient history, such as medications, illnesses, or recent surgeries.
** The information provided is current as of December 1, 2024, and may be subject to change.Always refer to the latest CPT coding guidelines and payer-specific policies for the most up-to-date information.
- Revenue Code: T1H - LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE)
- Payment Status: Active
- Specialties:Urology, Fertility, Reproductive Endocrinology
- Place of Service:Office, Independent Clinic, Outpatient Hospital, Fertility Clinic