Despite the demand and removal of the experimental designation, however, Dr. Rosen has not seen more insurance companies opt to cover the procedure. Only 15 states mandate benefit coverage for certain infertility services, including cryopreservation, but the laws vary widely. Most states require coverage only after a patient has been diagnosed as infertile.
Dr. Mitchell Rosen
“For patients who are undergoing medical treatment that would render significant reproductive impairment, that doesn’t matter to insurance companies,” Dr. Rosen said. “This is [considered] a completely elective procedure.”
Dr. Hill said he is optimistic that the coding change could move more insurers to cover cryopreservation, especially in states that already mandate in-vitro fertilization coverage. “If more insurers companies cover the procedure, certainly, it’s going to help patients access the treatment,” he said.
Dr. Rosen is not certain if the coding difference will change how frequently the procedure is covered, but he strongly supports coverage for cryopreservation in cases in which women are likely to have significant reproductive impairment because of medical treatment.
“If it’s one step in the right direction of it ultimately being covered, then that’s great,” he said. “But I don’t know if changing the CPT code is going to make a difference.”
Meanwhile, the cryopreservation of immature oocytes remains experimental because there is insufficient clinical data to support its use in many clinical applications, according to ASRM. A new Category III CPT code (0357T) has been introduced for reporting cryopreservation of immature oocytes.
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