Effective July 1, 2021, fertility preservation for iatrogenic infertility is covered for fully insured commercial members who are on a new plan or upon renewal of their existing plan after this date.
You’ll need to complete the prior authorization process and provide any applicable medical documentation when requesting fertility preservation for iatrogenic infertility for certain CPT® codes. These codes must be billed with the ICD-10 code Z31.84.
For the benefit to apply, the member must have an upcoming medical treatment that causes irreversible infertility, such as chemotherapy, radiation treatment and bilateral oophorectomy, due to cancer. Services include the following procedures, when provided by or under the care or supervision of a physician:
How to submit prior authorization and notification
Learn how to check requirements, submit new authorizations / notifications, check status, and submit updates by registering for live event or using the Prior Authorization and Notification Interactive User Guide.