How To Use CPT Code 84270

CPT 84270 describes the measurement of sex hormone binding globulin (SHBG) in patient blood. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 84270?

CPT 84270 can be used to measure the levels of sex hormone binding globulin (SHBG) in patient blood. This test is typically ordered by clinicians to evaluate male patients for issues related to testosterone deficiency, such as infertility, erectile dysfunction, or decreased sex drive. In female patients, the test may help diagnose hormone imbalance problems due to excess testosterone produced by the ovaries, such as lack of a menstrual cycle, polycystic ovarian syndrome, or hirsutism.

2. Official Description

The official description of CPT code 84270 is: ‘Measurement of sex hormone binding globulin (SHBG).’

3. Procedure

1. The lab analyst collects a specimen, typically patient blood, to perform the test.
2. The lab analyst mixes the specimen with specific substances to measure the levels of SHBG.
3. The test may use methods such as immunoassay, where levels of SHBG antigens in blood react with reagent antibodies.
4. The lab analyst measures the amount of the antigen-antibody combination to determine the amount of SHBG in the blood.

4. Qualifying circumstances

CPT 84270 is typically ordered by clinicians to evaluate male patients for testosterone deficiency or female patients for hormone imbalance problems due to excess testosterone. It is not limited to testing for a specific condition, but it is important to note that clinicians do not routinely order this test. Instead, they may order other tests such as CPT 84402 (Testosterone; free) or CPT 84403 (Testosterone; total).

5. When to use CPT code 84270

CPT code 84270 should be used when a clinician orders a test to measure the levels of sex hormone binding globulin (SHBG) in patient blood. It is important to note that this test is not routinely ordered and may be replaced by other tests depending on the specific clinical scenario.

6. Documentation requirements

To support a claim for CPT 84270, the clinician must document the following information:

• Reason for ordering the test, such as evaluating testosterone deficiency or hormone imbalance
• Date of the test
• Results of the test, including the levels of SHBG
• Signature of the clinician ordering the test

7. Billing guidelines

When billing for CPT 84270, ensure that the test is medically necessary and ordered by a clinician. It is important to note that this test is not routinely ordered, and other tests may be more appropriate in certain clinical scenarios. Some payers may pay separately for collecting the specimen using a code such as CPT 36415 (Collection of venous blood by venipuncture).

8. Historical information

CPT 84270 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates to the code since its addition.

9. Examples

1. A clinician orders CPT 84270 to measure the levels of sex hormone binding globulin (SHBG) in a male patient presenting with symptoms of testosterone deficiency.
2. A clinician orders CPT 84270 to evaluate a female patient with polycystic ovarian syndrome and suspected hormone imbalance due to excess testosterone.
3. A clinician orders CPT 84270 to assess the levels of SHBG in a male patient experiencing erectile dysfunction.
4. A clinician orders CPT 84270 to investigate the hormone levels in a female patient with hirsutism.
5. A clinician orders CPT 84270 to measure the levels of SHBG in a male patient with infertility issues.
6. A clinician orders CPT 84270 to evaluate a female patient with amenorrhea and suspected hormone imbalance.
7. A clinician orders CPT 84270 to assess the levels of SHBG in a male patient with decreased sex drive.
8. A clinician orders CPT 84270 to investigate the hormone levels in a female patient with irregular menstrual cycles.
9. A clinician orders CPT 84270 to measure the levels of SHBG in a male patient with symptoms of testosterone deficiency, including fatigue and decreased muscle mass.
10. A clinician orders CPT 84270 to evaluate a female patient with hirsutism and suspected hormone imbalance.