Patient tools for finding the best IVF clinics, infertility care and support

May 3, 2017Carole 4 Comments »

Chapter 10: Patient Tools (from e-book Fertility Lab Insider, available on Amazon,)

Questions for the RE and Clinic
About the Reproductive Endocrinologist:
Board certified in Reproduction, Endocrinology and Infertility? Years experience? How many years has this program been open?
Number of REs in the group?
Do patients see same physician, nurses each time?
Where does the physician have hospital privileges?
Is physician/lab “in network” for patient’s insurance plan?

Communication questions:
How do patients reach the doctor to ask questions? Email? Phone? or messages relayed through the nurse?
How are emergency after hour calls handled?

Questions at first consult:
What diagnostic tests will you order for patient? partner? How much will these tests cost?
Next steps questions:
Based on the diagnostic work-up , what treatment plan do you recommend?
For patients just like me (age, diagnosis), what kind of success rate can I expect?
Do you recommend ovulation induction cycles for me? If so, how many OI cycles do you recommend before you typically recommend IVF?

Questions about the Lab:

Is the lab accredited by CAP or Joint commission?

How many Andrology techs do you have?

How many Embryology techs do you have?

Are techs cross-trained? Try to determine if backup techs are available for emergency absences.

When is the lab closed for down times?

Does you lab offer ICSI, assisted hatching, donor egg or embryo? or embryo biopsy for PGD?

Are your success rates reported to SART or CDC?

Do you perform procedures (IUI and IVF) on weekends?

What is your rate of twin? triplets? With IVF?

What has been your experience with elective single embryo transfer?

Questions about Payment for Services:

Will I receive a written estimate of my self-pay costs?

Are these costs inclusive (physician fees, medications, ultrasounds, blood work, lab fees)?

Will you provide me with CPT codes I can use to discuss with my insurance company?

Do you offer financial assistance, payment plans or Shared Risk programs?

 

LIST OF LAB CPT Codes

Ask your doctor to provide the CPT codes with your itemized estimate for each lab procedure or test that is ordered for you. The codes below are the procedure codes you can reference when identifying your covered procedures with your insurance company for your treatment plan. The bottom of the second page has a space for various additional codes your physician will submit for office consults, ultrasound exams, physician surgical procedures and other physician prescribed interventions that are not on the lab procedure list.

INSURANCE CODES FOR LABORARTORY WORK

IVF CODES
89254 Oocyte Identification From Follicular Fluid. This code refers to the work of identifying the oocytes contained in the follicular fluid aspirated at the time of the oocyte retrieval.

(Note that physician codes for retrieval also exist. For example 58970 for follicle puncture for oocyte retrieval, (any method)

89268 Insemination of Oocytes.This code includes the work involved in conventional in vitro insemination of oo- cytes.

89280 Assisted Oocyte Fertilization, Microtechnique; Less Than or Equal to 10 Oocytes (89281; Greater Than 10 Oocytes)

89250 Culture of Oocyte(s)/Embryo(s), Less Than 4 Days

89251 With Co-Culture of Oocyte(s)/Embryo(s). This code includes all of the work described by culture of oocyte(s)/embryo(s) (89250) with the additional work of co-culturing the embryos with feeder cells (granulosa, endometrial, tubal, etc.)

89272 Extended Culture of Oocyte(s)/Embryo(s), 4–7 Days. This code applies to the continuation of oocyte/embryo culture in excess of 3 days and is reported in addition to the culture of oocyte(s)/embryo(s), less than 4 days (89250, 89251).

89255 Preparation of Embryo for Transfer (Any Method). This code includes the following work: removing the embryo(s) from culture, preparing the embryo(s) for transfer, loading the embryo(s) into an appropriate catheter, transporting the embryo(s) to the transfer room for transfer to the patient, and examination of the catheter after transfer to ensure that no embryo(s) are retained.

PGD CODES

89290 Biopsy, Oocyte Polar Body or Embryo Blastomere, Microtechnique (for Preimplantation Genetic Diagnosis); Less Than or Equal to 5 Embryos

89291; Biopsy, Greater Than 5 Embryos

SEMEN ANALYSIS CODES

89300 presence and/or motility of sperm including Huhner test (postcoital)

89310 semen analysis; motility and count

89320 semen analysis; complete (volume, count, motility, and differential)

89280, 89281 assisted oocyte fertilization, microtechnique (any method)

89257 sperm identification from aspiration (other than seminal fluid

89264 sperm identification from testis tissue, fresh or cryopreserved

 

QUICK LINKS

Patient Tools: Searchable CDC Databases of Annual Outcomes Reported by US Fertility Clinics

CDC pregnancy outcomes: CDC Introduction page- What is ART?

CDC ART Reports for previous years List of links to reports for previous years for both national summaries and individual clinic reports.

Link to searchable fertility center results Select the State, Clinic, and Report Year to generate custom report for each reporting clinic.

Link to National Summary Table for all US CDC Reports, select the year for the National Summary Report you want. SART reported pregnancy outcomes: subset of CDC reports

Patient Tools: FDA Searchable databases

Warning letters issued to non-compliant FDA facilities including ART clinics

Searchable list of registered FDA screening facilities, Find registered facilities that perform eligibility screening of tissue donors.

Reproductive Health:

American Society for Reproductive Medicine (ASRM) The main professional society for physicians, nurses and lab technicians who provide ART services. Professional Guidelines can be viewed here as well as various patient resources for couples struggling with infertility.

Association of Reproductive Health Professionals Professional Society for Reproductive Health Care Professionals; not specific for infertility.

CDC Reproductive Health page Main page for reproductive health: ART is only one of eight broad areas, including ART, Infertility, Sudden Infant Death Syndrome, Unplanned Pregnancy, Global Reproductive Health, Maternal and Infant Health, and Teen Pregnancy.

Infertility Support Groups:

RESOLVE “The National Infertility Association, established in 1974, is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders.”

Fertile Hope “Fertile Hope is a national LIVESTRONG initiative dedicated to providing reproductive information, support and hope to cancer patients and survivors whose medical treatments present the risk of infertility.”

INCIID “The InterNational Council on Infertility Information Dissemination (INCIID – pronounced “inside”) is a nonprofit organization that helps individuals and couples explore their family-building options. INCIID provides current information and immediate support regarding the diagnosis, treatment, and prevention of infertility and pregnancy loss, and offers guidance to those considering adoption or childfree lifestyles.”

Fertile Thoughts “the leading online community for women and men to talk
about fertility, infertility, pregnancy and parenting.”

Fertility Preservation before Cancer Treatment:

My Oncofertility, website filled with patient support resources

Oncofertility Consortium, NIH supported initiative to advance research and patient options for fertility preservation.

Your Healthcare, Your Way: Participatory Medicine

The Society for Participatory Medicine The Society was founded to learn about and promote Participatory Medicine through writing, speaking, social networking, and other channels.

e-patient.net A blog for patients and physicians who agree that working together makes the best healthcare.

More Information on Adoption and Infertility treatments:

Creating A Family Website offers some great links and information on adoption and also on IF.

Support for dealing with grief and loss

Grief, Interrupted, Meet Michelle Buzgon, certified life and grief coach and read her blog which is about recognizing and honoring all kinds of loss.

When ART Works: Pregnancy Resources

Preconception Care: March of Dimes Website

Safe Pregnancy Advice: MotherRisk Website, a pregnancy counseling, education and outreach program created by the Hospital for Sick Children in Toronto, Canada

 

© 2017, Carole. All rights reserved.

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