89344
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Key Coverage Criteria
- Cryopreservation of mature oocytes is consideredmedically necessarywhen the following criteria are met:Individual is a candidate based on ovarian reserve and likelihood for successful oocyte cryopreservation (for example, age 45 years or less);andPost-pubertal;andFacing anticipated infertility resulting from medical or surgical treatment, including chemotherapy, radiation therapy, other gonadotoxic therapies, or bilateral oophorectomy;andAnticipated infertility is NOT the result of the following [...]
- Individual is a candidate based on ovarian reserve and likelihood for successful oocyte cryopreservation (for example, age 45 years or less);and
- Post-pubertal;and
- Facing anticipated infertility resulting from medical or surgical treatment, including chemotherapy, radiation therapy, other gonadotoxic therapies, or bilateral oophorectomy;and
- Anticipated infertility is NOT the result of the following:Sterilization services, when not for treatment of an illness, injury or disease or its symptoms;orNormal reproductive aging.
- Sterilization services, when not for treatment of an illness, injury or disease or its symptoms;or
1 Active Policy
ANTHEM-CG-MED-66 — CG-MED-66 Cryopreservation of Oocytes or Ovarian Tissue
Related Codes
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