CPT 89325 · Anti-Sperm Antibody Add-On
89325 is the anti-sperm antibody test. It's a separate line added to a semen analysis, not part of the standard 89320 or 89322, and current guidelines say it doesn't belong in a first workup. Here's what it covers, when a urologist actually orders it, and how to get the analysis it's built on.
Anti-sperm antibodies are immune proteins that stick to sperm and can make them clump together or move poorly. They can form after the blood-testis barrier is breached: vasectomy, testicular injury or infection. CPT 89325 is the lab test that looks for them. Hera's standard order is the semen analysis, which is where the clue for this test usually shows up; a urologist or fertility clinic adds 89325 when it's warranted.
$60 physician order + the lab's cash price for the semen analysis (roughly $75–$300), confirmed before your visit
CPT 89325 is a test for antibodies directed against sperm. The usual method is the mixed antiglobulin reaction (MAR) or an immunobead test: tiny beads coated with anti-antibody are mixed with fresh semen, and the lab counts what share of the motile sperm end up with beads stuck to them. Per WHO, 50% or more bound motile sperm is the level generally treated as clinically significant. Some labs run it on blood serum instead, which detects circulating antibodies but says less about what's happening to the sperm themselves.
It is not included in a semen analysis. CPT 89320 and 89322 cover volume, count, motility and morphology; if a lab runs the antibody test it bills 89325 as an additional line. Many labs, including most general reference labs, have stopped offering it, because a strongly positive result usually leads to the same treatment, IUI or IVF with ICSI, that a couple would be offered anyway for the underlying problem. Where it's still run, it's typically at andrology labs attached to fertility clinics.
1. Place a semen analysis order with Hera. Tell us where you are and we match you to a lab near you; many labs in our network are fertility-clinic and andrology labs, the kind that can also run anti-sperm antibodies if it's needed later. Hera's physician signs the order.
2. We text or email you the lab's location, cash price and collection instructions within one business day. The order requests the complete semen analysis with diagnosis code Z31.41. If a urologist has already asked you to add anti-sperm antibodies, bring that order too: 89325 has to be requested separately and run on a fresh sample.
3. Upload the report and Hera's AI reads every parameter against WHO 2021 limits. If it shows agglutination, or low motility with a normal count and morphology, that's the pattern where a urologist may add 89325, and the report gives you something concrete to bring to that visit.
Anti-sperm antibody testing only makes sense on top of a semen analysis, so that's where to start. Submit your order and we match you to a lab. Already have a report that mentions agglutination or low motility? Upload it for a free AI reading.
Order a semen analysis — we'll match you to a lab Upload your resultsEvery lab order carries a CPT code (what the lab runs) and an ICD-10 diagnosis code (why it was ordered). If you bring your own order, or want to check what your insurance will see, these are the codes to look for.
| Code | What it covers |
|---|---|
| 89325 (Add-on ordered by a urologist) | Anti-sperm antibody test — antibodies bound to sperm (mixed antiglobulin reaction or immunobead) or measured in blood. An add-on, not part of the standard analysis. |
| 89320 | Complete semen analysis — the test the antibody screen is added to. |
| 89322 | Complete semen analysis with strict (Kruger) morphology — the same, at fertility-clinic and andrology labs. |
| Code | What it covers |
|---|---|
| Z31.41 (Add-on ordered by a urologist) | Encounter for fertility testing. |
| N46.8 | Other male infertility — when agglutination or isolated low motility prompted the test. |
| N46.9 | Male infertility, unspecified. |
89325 is billed on top of the semen analysis, so expect two lines on the claim. Coverage follows the diagnosis: with Z31.41 it's treated as fertility testing, which many plans exclude; with N46.8 after a documented cause it's more likely to be paid. Ask the lab whether it runs the test on semen (MAR or immunobead) or serum before you pay for it, since the two aren't equivalent.
CPT 89325. It covers testing for antibodies against sperm, most often by a mixed antiglobulin reaction (MAR) or immunobead test on fresh semen, sometimes on blood serum. It's billed as a separate add-on line; the semen analysis it accompanies is billed as CPT 89320 or 89322.
No. A semen analysis (89320 or 89322) reports volume, count, motility and morphology. Some reports note agglutination, meaning sperm sticking together, which is a hint that antibodies may be present, but the antibody test itself is a separate order and a separate charge. Hera's standard order is the semen analysis; 89325 is something a urologist or fertility clinic adds.
The AUA/ASRM male infertility guideline (2020, amended 2024) says clinicians should not perform anti-sperm antibody testing as part of the initial evaluation. It's reserved for specific findings: agglutination on the analysis, poor motility with an otherwise normal sample, persistent problems after a vasectomy reversal, or a history of testicular injury, torsion, infection or obstruction.
On a MAR or immunobead test, the lab reports the percentage of motile sperm with beads attached. WHO treats 50% or more as the threshold likely to affect fertility; lower percentages are common and usually not meaningful on their own. Serum tests report a titer instead and correlate less well with what's happening in the semen.
Because the result rarely changes the plan. A couple with a strongly positive test is usually offered intrauterine insemination or IVF with ICSI, which is the same path they'd be offered for the low motility or agglutination that prompted the test. Steroid treatment to suppress the antibodies has fallen out of favor because of side effects. Labs attached to fertility clinics still run it when a specialist wants the information.
Z31.41, encounter for fertility testing, when it's part of a workup. N46.8, other male infertility, when a specific cause such as a prior vasectomy or testicular injury is documented. N46.9, male infertility unspecified, when the analysis is abnormal without a known cause.
It's usually quoted as an add-on to the semen analysis rather than as a stand-alone price, and it varies a lot by lab, so ask for the combined cash price. The semen analysis itself runs roughly $75 to $300 in the US. Hera charges a $60 physician-order fee for the analysis and confirms the lab's price before your visit.