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Obesity and Infertility Billing Service


Obesity is a serious illness that can disrupt daily life, including basic physical functions like breathing and walking. Obese people are also more likely to develop diabetes, sleep apnea, gastroesophageal reflux disease (GERD), high blood pressure, and joint pain.


Obesity is identified by calculating the Body Mass Index (BMI). BMI is defined as the ratio of a person’s height to weight.


Overweight: BMI ranges from 25.0 to 29.9.


Obese: BMI ranges from 30.0 to 39.9.


Severe obesity: BMI of 40.0 or greater, or 35.0 – 39.9 with obesity-related health conditions

Common obesity-related Conditions

Obesity-related health problems shorten people’s lives. The following are some of the more common conditions. Please consult your doctor if you require any additional information.

  • Diabetes type 2.
  • Heart disease/high blood pressure
  • Weight-bearing joint osteoarthritis
  • Sleep apnea/respiratory issues
  • Gastroesophageal reflux disease (GERD) (hiatal hernia and heartburn).
  • Incontinence due to urinary stress

Fertilization Treatment Billing and Coding

Infertility is the inability to achieve pregnancy after at least a year of regular, unprotected intercourse. According to the Department of Health and Human Services, approximately 12 to 13 couples out of every 100 have difficulty conceiving in the United States (HHS). In vitro fertilization (IVF), the most common assisted reproductive technology (ART), allows many couples who have failed other infertility treatments to become pregnant. The codes used to report diagnoses and treatments have grown in number over time, paralleling the variety and complexity of ART. Using infertility billing and coding services, gynecologists and fertility specialists can accurately report their work and the diagnoses that support it.


An efficient reproductive endocrinology billing process requires complete and accurate documentation of all procedures. Furthermore, accurate claim submission is heavily reliant on insurance knowledge, as IVF coverage varies greatly between insurance plans. Insurance verification services can help with this.

Infertility Causes

Many factors can prevent sperm and egg from spontaneously uniting. Infertility causes can exist from birth or develop later, and they can affect one or both partners. The most common causes of infertility in women are ovulation problems and blocked fallopian tubes. Other causes include endometriosis, early menopause, pelvic adhesions, abnormalities of the uterus or cervical region, and some cancers and cancer treatments. Male infertility can be caused by abnormal sperm production or function, sperm delivery issues, infection, injury, toxicity exposure, chromosomal abnormalities, and systemic diseases. Other risk factors include smoking, alcohol consumption, obesity, and advanced age.


Infertility treatments range from simple interventions like fertility drugs to induce ovulation to more complex options like artificial insemination, IUI sperm injections, and in vitro fertilization (IVF).

What is IVF? When Is It Considered?

IVF is a type of assisted reproduction in which mature eggs are extracted from a woman’s ovaries and manually combined in a laboratory dish with a man’s sperm. Later, the fertilized egg or embryo is placed in the uterus. The IVF procedure includes the following complicated steps:

Ovarian stimulation

is the use of medications or fertility drugs to stimulate the growth of multiple eggs in the ovaries.

Egg retrieval

is typically accomplished through a minor surgical procedure known as transvaginal ultrasound aspiration or through the use of laparoscopy.

Fertilization and embryo culture

entail assessing the maturity and quality of the retrieved eggs. For the embryos to develop, sperm is added to selected mature eggs.

Embryo transfer

entails inserting one or more embryos into the uterus. The number of embryos transferred is determined by the patient’s age as well as other patient and embryo characteristics. The risk of high-order multiple gestations is minimized.


Donor eggs, donor sperm, or previously frozen embryos can all be used in ART procedures.


When other infertility treatments fail, couples consider IVF. IVF, on the other hand, may be offered as a primary treatment for infertility in women over the age of 40. According to the Mayo Clinic, IVF may be an option for couples who have one or more of the following conditions:


  • Fallopian tube damage or obstruction


  • Ovulation problems


  • Endometriosis


  • Fibroids in the uterus


  • Tubal sterilization or removal in the past


  • Sperm production or function issues


  • Unexplained infertility


  • A genetic disorder


  • Fertility preservation for cancer or other health problems

IVF Treatment Health Insurance

Understanding health insurance coverage for infertility treatments can be difficult. When it comes to IVF treatment coverage, health plans have different rules. Some plans exclude IVF coverage. Some plans cover both IVF and the injections associated with the procedure. Other plans may cover IVF but not the injections. While providers correctly document services, submission of a code does not guarantee reimbursement. Other policies and guidelines for coverage determination may apply to the member’s plan.


Candidates for infertility treatment are not automatically eligible for services covered by their insurance plan. Certain pre-treatment procedures for fertility services may be required by insurance plans. All fertility treatments require prior authorization from many insurers.


Insurance verification and prior authorization assistance can benefit both patients and providers. A specialist in insurance verification will:


  • Contact the insurance company soon after the initial consultation with the gynecologist to determine the candidate’s plan requirements and benefits.


  • Determine whether diagnostic testing is covered.


  • Confirm whether the candidate’s infertility treatment coverage includes IVF, intracytoplasmic sperm injections (ICSI), cryopreservation (freezing of embryos or sperm), or egg donor treatment.


  • Is precertification necessary for infertility treatment?


  • Deductibles, co-pays, and co-insurance for infertility-related expenses

Medical Coder’s Obesity and Infertility Billing Service

Medical Coder is a leading medical billing and coding company in the medical outsourcing industry, focusing on all aspects of revenue cycle management. Medical billing companies that specialize in obesity, infertility, and reproductive endocrinology billing and coding can assist gynecology practices in overcoming all of these coding and claim submission challenges. This will allow providers to concentrate on assisting patients in overcoming their fertility challenges. Our medical billing services adhere to practices that fully support major healthcare insurance companies such as Aetna, Oxford, United, HIP, GHI, BCBS, Medicare, Medicaid, Humana, and EMI.


Our medical billing and coding professionals ensure quick turnaround and accurate results.




Medical Coder company always build a healthy and trustable relation with his clients. Our trained and well experienced staff objective is to give 100% results as per our customers demand. Our main focus is customer satisfaction.