27.08.2019
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Posted by Provider Relations
Effective October 1, 2019, Ovulation enhancing drugs and related medical services are covered when billed with the appropriate infertility diagnosis codes: E22.1, E28 through E28.x, E23.0, L68.0, N97.0 or Z31.41. Related lab services are covered. Related ultrasound codes 76856, 76857, and 76830 are covered and require prior authorization through eviCore Healthcare. 76856, 76857, and 76830 have a combined lifetime limit of 10.
74740 and 76831 (billed with 58340) are covered and could be rendered separately. 74740 and 76831 have a combined lifetime limit of 1. 76831 requires prior authorization through eviCore Healthcare.