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Infertility Services - Cigna

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Page 1 of 45 Medical Coverage Policy: 0089 Medical Coverage Policy Effective Date ........................................ ....10/15/2021 Next Review Date ....................................... 6/15/2022 Coverage Policy Number .................................. 0089 Infertility Services Table of Contents Overview ........................................ ...................... 1 Coverage Policy ........................................ ........... 1 General Background ........................................ .... 5 Medicare Coverage Determinations .................. 22 Coding/Billing Information.

• sperm extraction and retrieval procedures such as: electroejaculation, microsurgical epididymal sperm aspiration (MESA), testicular sperm aspiration (TESA), testicular fine needle aspiration (TEFNA), testicular sperm extraction (TESE), microscopic-TESE, percutaneous epididymal sperm aspiration (PESA), vasal sperm aspiration, and seminal ...

  Extraction, Sperm, Testicular, Sperm extraction, Testicular sperm, Testicular sperm extraction

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