CPT 89398 · Unlisted Procedure
There isn't one. Labs bill the DNA fragmentation index (DFI) under an unlisted code, 89398, which is why it's a cash-pay test almost everywhere. Here's what that means and how to get it.
Sperm DNA fragmentation testing (SCSA, TUNEL, Comet, Halo) measures breaks in sperm DNA that a standard semen analysis can't see. Because no dedicated CPT code exists, insurers have no fee schedule for it and rarely pay. Hera lists the specialty labs that run it, with the cash price, and the physician order is included.
$60 physician order + the lab's cash price, shown before you book
CPT 89398 is 'unlisted reproductive medicine laboratory procedure'. The AMA never assigned a specific code to sperm DNA fragmentation assays, so labs file the SCSA, TUNEL, Comet or sperm chromatin dispersion (Halo) test under this catch-all; a few use 84999, the unlisted chemistry code, instead. Either way the claim goes in with a description and a price the lab sets.
An unlisted code has no insurer fee schedule behind it. Plans usually ask for records, deny it as experimental, or pay a fraction. That's why nearly every lab treats DFI as a cash-pay test — and why the semen analysis run on the same sample (CPT 89320) is often billed separately and may be covered when the DFI isn't.
1. Pick a specialty lab on Hera — DFI runs at andrology and fertility-clinic labs, not at general draw sites. The cash price and the assay (SCSA, TUNEL, Comet) are listed.
2. Your physician-signed order requests the DNA fragmentation test and, if you want it on the same sample, the complete semen analysis (89320). No visit to a urologist first.
3. Upload the report. Hera's AI explains your DFI alongside your other parameters and flags what to do next — repeat, treat a cause, or discuss ICSI with your clinic.
Availability is limited to specialty labs. Search by ZIP to see the ones near you with prices, or read what the test measures first.
Find a DNA fragmentation lab What the DFI test measuresSperm DNA fragmentation has no CPT code of its own, which is the main reason it's usually paid out of pocket. These are the codes labs actually put on the claim, and the diagnoses that go with them.
| Code | What it covers |
|---|---|
| 89398 (On a Hera order) | Unlisted reproductive medicine laboratory procedure — there is no dedicated code for sperm DNA fragmentation, so most labs bill SCSA, TUNEL or Comet testing under this one. |
| 84999 | Unlisted chemistry procedure — the other unlisted code some labs use for a DNA fragmentation index (DFI). |
| 89320 | Complete semen analysis — usually run on the same sample, and often required by the lab alongside the DFI. |
| Code | What it covers |
|---|---|
| N46.9 (On a Hera order) | Male infertility, unspecified — the usual diagnosis when DFI is ordered after a normal semen analysis or failed IUI/IVF. |
| N46.8 | Other male infertility — used when a specific cause (varicocele, prior chemotherapy) is already documented. |
| Z31.41 | Encounter for fertility testing. |
If you want to try insurance, ask the lab for the claim with 89398 (or 84999), the assay name, and N46.9, and submit it yourself — expect a request for records. The semen analysis on the same sample (89320) is a listed code and is the part most likely to be covered.
There isn't a dedicated one. Most labs bill SCSA, TUNEL, Comet and Halo testing under CPT 89398, unlisted reproductive medicine laboratory procedure. Some use 84999, unlisted chemistry. Both are catch-all codes with no fixed insurer fee.
Rarely. Unlisted codes have no fee schedule, so plans typically request records and deny the test as investigational, or reimburse only part of it. Treat DFI as a cash-pay test and check whether the semen analysis run alongside (89320) is covered separately.
N46.9, male infertility unspecified, in most cases. N46.8, other male infertility, when a specific cause such as a varicocele is documented. Z31.41, encounter for fertility testing, if it's part of an initial workup.
No — they're different laboratory methods for measuring the same thing, and all are billed under the same unlisted code. The assay name goes in the claim's description. Results aren't directly interchangeable between methods, so repeat testing should use the same assay.
Cash prices at US specialty labs commonly run from about $150 to $500 depending on the assay and whether a semen analysis is included. Hera lists the exact price for each location and charges a $60 physician-order fee.
Usually. Most labs require or strongly recommend a complete semen analysis (CPT 89320) on the same sample, and the DFI is far more useful read together with count, motility and morphology. Hera's AI reads both together.