Summary & Overview
HCPCS A9293: Fertility Cycle Tracking Software Application, Monthly
HCPCS Level II code A9293 covers an FDA-cleared fertility cycle tracking software application, billed monthly and including accessories such as a thermometer. This code captures a growing category of digital health tools used for contraception management and conception planning. Nationally, such codes matter as payers and regulators adapt coverage policies for software-as-a-medical-device products that combine remote monitoring, consumer devices, and clinical decision support.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations across major payers, common billing and coding elements associated with this HCPCS Level II entry, and the clinical context for use in family planning and fertility monitoring. The publication summarizes typical service settings, accessory inclusion, and implications for monthly billing frameworks.
The analysis highlights benchmarks and policy updates relevant to digital fertility tools, clarifies what the code represents for billing workflows, and outlines the clinical scenarios where monthly device-plus-software billing is applicable. Data not available in the input is noted where payer-specific rates, utilization metrics, or associated ICD-10 pairings are not provided.
Billing Code Overview
HCPCS Level II code A9293 describes a fertility cycle tracking software application cleared by the FDA, billed per month, and includes accessories such as a thermometer. The service type is digital health application for contraception and conception tracking, delivered primarily as a remote or ambulatory patient-facing software service often used in home settings or outpatient clinics. Typical site of service is home-based use or outpatient/telehealth environments where the patient uses the application and included accessories to monitor fertility indicators.
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Clinical & Coding Specifications
Clinical Context
A 32-year-old person attempts to conceive and uses a Food and Drug Administration–cleared fertility cycle tracking software application billed as A9293 on a monthly basis. The patient receives the device and accessories (for example, a digital basal thermometer) through an outpatient durable medical equipment or remote patient monitoring workflow. The clinical workflow includes initial counseling by an obstetrics-gynecology or reproductive endocrinology clinician during an office visit, enrollment in the software platform, instruction on accessory use (thermometer placement and measurement timing), and data transmission or synchronization to the clinician portal. The application passively and actively collects daily temperature, menstrual cycle input, optional ovulation test results, and symptom logs. The clinician reviews trend reports remotely or during follow-up visits to advise on timing for conception, to identify cycle irregularities, or to escalate evaluation for infertility when appropriate. Typical site of service is outpatient clinic or telehealth enrollment with home use of the software and accessories. Common modifiers that may apply include TC for the technical component of the software accessory, 26 for clinician professional interpretation when billed separately, and AS for ambulatory surgical center billing scenarios when bundled with other services.
Coding Specifications
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