2025 HCPCS code G0027

Semen analysis to determine the presence and/or motility of sperm, excluding the Huhner test.

Adhere to current HCPCS coding guidelines and payer-specific instructions. Correct documentation is crucial for appropriate reimbursement.

Modifiers may apply depending on the circumstances of service delivery. Consult payer-specific guidelines and current coding resources for modifier application rules.

Medical necessity for G0027 is established when there is a clinical indication for evaluating male fertility or assessing the success of a vasectomy.This may include symptoms of infertility, post-vasectomy follow-up, or evaluation after testicular trauma.Documentation must clearly support the clinical need for the test.

The clinical responsibility lies with the laboratory personnel who perform the microscopic analysis of the semen sample. The ordering physician is responsible for medical necessity and appropriate interpretation of results.

IMPORTANT CPT code 89321 (Semen analysis; sperm presence and motility of sperm, if performed) may be used for some commercial payers, but G0027 is the preferred code for Medicare and Medicare-following payers.The choice depends on the specific payer's requirements.

In simple words: This lab test checks a semen sample under a microscope to see if there is sperm and if it's moving. It doesn't include a specific test that checks how the sperm interacts with fluid from the cervix.

This HCPCS code, G0027, represents a semen analysis performed to assess the presence and/or motility (movement) of sperm in a semen sample.The analysis does not include the Huhner test, which involves examining sperm interaction with cervical mucus. The procedure involves microscopic examination of the semen sample to determine sperm presence and, if present, their motility. This test is often used to evaluate male infertility or assess the success of a vasectomy.

Example 1: A patient presents post-vasectomy to confirm sterilization. A semen analysis (G0027) is ordered to check for the presence of sperm., A couple experiencing infertility undergoes testing.As part of the male partner's evaluation, a semen analysis (G0027) is performed to assess sperm count and motility., Following a trauma to the testicles, a semen analysis (G0027) is ordered to assess for potential damage affecting sperm production or motility.

* Patient demographics and identifying information.* Reason for the test (e.g., post-vasectomy, infertility evaluation).* Date and time of semen sample collection.* Method of semen collection.* Detailed laboratory report including results of the analysis (presence and motility of sperm).* Physician's order for the test and interpretation of results.

** Always verify the specific requirements of the payer before submitting the claim.Keep abreast of any updates to HCPCS coding guidelines and relevant medical policies.This information is for guidance only; it does not constitute legal or medical advice.

  • Payment Status: Active
  • Modifier TC rule: The technical component (TC) modifier typically applies to laboratory tests.
  • Specialties:Urology, Reproductive Endocrinology, Andrology
  • Place of Service:Laboratory, Physician's Office
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