Summary & Overview
CPT 58322: Intrauterine Insemination (Insertion of Prepared Sperm)
CPT code 58322 identifies intrauterine insemination (IUI), a reproductive medicine procedure in which prepared live sperm are placed directly into the uterus via the cervical canal. This code captures a commonly used fertility intervention that affects coverage, access, and billing practices nationwide because of its frequency in outpatient reproductive care and its variable coverage across payers. Major payers included in national coverage discussions are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise briefing on the clinical context for IUI, typical sites of service, and why correct coding matters for claims processing and patient access. The publication summarizes payer coverage patterns and benchmarks where available, highlights common billing considerations and allowed modifiers, and outlines policy and reimbursement topics that influence utilization. Data not available in the input will be noted where relevant. This resource is intended to inform coding professionals, practice managers, and policy analysts about the role of CPT code 58322 in reproductive health billing and policy.
Billing Code Overview
CPT code 58322 describes a procedure in which the provider inserts prepared live sperm into the uterus through the cervical canal. This service is an intrauterine insemination (IUI) procedure.
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Service type: Reproductive medicine procedure (intrauterine insemination)
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Typical site of service: Ambulatory clinic or outpatient reproductive endocrinology/infertility center where minor invasive procedures are performed
Clinical & Coding Specifications
Clinical Context
A 34-year-old woman with a 2-year history of infertility presents to a reproductive endocrinology clinic for intrauterine insemination (IUI). She has regular menstrual cycles and normal ovulatory function after ovulation induction with clomiphene citrate. Her partner provided a semen sample that was processed by the andrology laboratory to isolate motile, prepared sperm. On the day of ovulation, the patient presents to the outpatient clinic early in the morning. A transvaginal ultrasound confirms a dominant follicle; the provider performs the procedure by inserting prepared live sperm through the cervical canal into the uterine cavity using a sterile catheter. The procedure is performed in an ambulatory clinic procedure room; the patient is monitored briefly afterward for cramping or vasovagal symptoms and discharged the same day with routine post-procedure guidance. Typical payors covering this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare depending on plan coverage and state mandates.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management (E/M) service by the same physician on the day of a procedure | Use when a separate E/M visit is documented on the same day as the IUI for issues beyond routine procedural consent and counseling. |