CPT® Code 84270 is used to report a Sex Hormone Binding Globulin (SHBG) laboratory test, which measures the level of SHBG in the blood. SHBG is a glycoprotein that binds sex hormones—primarily testosterone and estradiol—and regulates their bioavailability in the body.
SHBG testing plays a key role in hormone evaluation, as abnormal levels can significantly impact how much “free” or biologically active hormone is available, even when total hormone levels appear normal. This test is commonly used in endocrine, integrative, functional, and women’s or men’s health settings.
CPT 84270 represents the laboratory test only. Interpretation, hormone management, or treatment planning is billed separately.
Key Facts About CPT® 84270
- Service type: Clinical laboratory blood test
- Provider type: Physicians, laboratories, and qualified healthcare professionals
- Medical services included: Quantitative measurement of sex hormone binding globulin
- Specimen type: Blood (serum)
- Common clinical indications:
- Evaluation of androgen or estrogen imbalance
- Investigation of symptoms of low or high testosterone
- Assessment of infertility or menstrual irregularities
- Monitoring hormone therapy or endocrine disorders
- Evaluation of metabolic or thyroid-related hormone changes
When to Use CPT® 84270
CPT 84270 is appropriate when:
- A blood sample is collected to measure serum SHBG levels
- Hormone-related symptoms require deeper evaluation beyond total hormone values
- Results will influence diagnostic decisions or hormone treatment planning
Examples:
- Evaluating low testosterone symptoms when total testosterone is normal
- Assessing estrogen availability in patients with menstrual irregularities
- Monitoring hormone optimization or replacement therapy
- Investigating metabolic conditions affecting hormone binding and availability
Documentation Requirements
To properly support CPT 84270 billing, documentation should include:
- Patient identifiers and date of specimen collection
- Ordering provider and clinical rationale for SHBG testing
- Confirmation that a serum SHBG test was performed
- Laboratory results and reference ranges
- Clinical follow-up plans or treatment adjustments
Accurate documentation supports medical necessity, audit readiness, and longitudinal hormone tracking.
Reimbursement and Coding Considerations
- CPT 84270 is typically covered by commercial payers and Medicare when ordered for medically necessary endocrine evaluation
- Coverage may depend on associated diagnoses such as hypogonadism, infertility, menstrual disorders, or metabolic conditions
- Interpretation and hormone management services are not included and must be billed separately
- Frequency limits and prior authorization requirements may apply depending on payer policies
- Always verify payer-specific coverage criteria
How OptiMantra Supports Hormone and Lab Management
OptiMantra’s integrated EMR and practice management platform is designed to support hormone-focused and specialty practices using CPT 84270.
With OptiMantra, providers can:
- Order SHBG testing directly within the patient chart
- Track SHBG trends over time alongside total and free hormone levels
- Correlate lab results with symptoms, diagnoses, and treatment plans
- Maintain audit-ready documentation for compliant billing
- Integrate hormone labs into comprehensive, personalized care pathways
By centralizing hormone labs, clinical notes, and billing workflows, OptiMantra enables practices to deliver precise, data-driven hormone care with confidence.
Try OptiMantra for free here!
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