2025 CPT code 89260
(Active) Effective Date: N/A Revision Date: N/A Laboratory - Semen Analysis Pathology and Laboratory Procedures > Reproductive Medicine Procedures Feed
Sperm isolation using simple preparation (e.g., sperm wash and swim-up) during semen analysis for insemination or diagnosis.
Modifiers may be applicable depending on the specific circumstances of service delivery.Consult the CPT manual for appropriate modifier usage.
Medical necessity for 89260 is established when a physician orders the procedure to prepare sperm for assisted reproductive technology (ART) procedures like IVF or IUI, or for diagnosing male infertility based on abnormal semen analysis findings. The need for the procedure should be documented in the patient's chart.
The clinical responsibility lies with the laboratory analyst who performs the technical steps of sperm isolation and preparation. The ordering physician is responsible for medical decision-making based on the results.
- Pathology and Laboratory Procedures > Reproductive Medicine Procedures
- Reproductive Medicine Procedures
In simple words: This lab test cleans and separates healthy sperm from a semen sample.It's used to prepare sperm for procedures like in-vitro fertilization (IVF) or to check for sperm problems.
This CPT code, 89260, encompasses the laboratory procedure of sperm isolation using a simple preparation technique, such as sperm wash or swim-up.This procedure is performed as part of a semen analysis to prepare sperm for insemination (e.g., in an in-vitro fertilization cycle) or for diagnostic purposes to evaluate sperm characteristics and identify abnormalities. The process may involve washing the sperm sample to remove excess fluid and debris and using an enrichment medium to promote the selection of motile, healthy sperm.
Example 1: A patient undergoing IVF treatment requires sperm preparation for insemination. The embryologist performs a sperm wash to improve the chances of successful fertilization., A male patient presents with infertility issues. The physician orders a semen analysis with sperm swim-up to evaluate sperm motility and morphology, aiding in the diagnosis of male infertility., A patient is undergoing intrauterine insemination (IUI) and requires a sperm preparation to improve the quality of sperm used for the procedure.
* Physician's order specifying the type of sperm preparation (wash or swim-up).* Complete patient demographics and identification.* Date and time of semen sample collection.* Detailed results of semen analysis including sperm concentration, motility, and morphology before and after preparation.* Method used for sperm preparation (specific details of wash or swim-up technique).
** This code is specifically for simple sperm preparation techniques. More complex procedures should be coded appropriately.Always refer to the most current CPT manual and guidelines for proper coding practices.
- Revenue Code: T1H (LAB TESTS - OTHER (NON-MEDICARE FEE SCHEDULE))
- RVU: Information not available in provided data. Requires consultation with official fee schedules and RVU databases.
- Global Days : Not applicable. This is a laboratory procedure, not a surgical procedure.
- Payment Status: Active
- Modifier TC rule: Not applicable.This is a laboratory procedure, not a surgical procedure with technical and professional components.
- Fee Schedule : Information not available in provided data. Requires consultation with historical fee schedules.
- Specialties:Reproductive Endocrinology and Infertility, Urology, Pathology
- Place of Service:Laboratory, Physician's office, Fertility Clinic