ICD-10 Coding for Testosterone Level Testing
For a patient requesting testosterone level testing, use ICD-10 code E29.1 (Testicular hypofunction) as the primary diagnostic code when clinical suspicion of testosterone deficiency exists based on symptoms or risk factors. If the patient is asymptomatic and requesting screening without clinical indication, use Z13.29 (Encounter for screening for other suspected endocrine disorder).
Clinical Context for Code Selection
The appropriate ICD-10 code depends on whether the patient has symptoms, signs, or risk factors suggesting testosterone deficiency:
When to Use E29.1 (Testicular Hypofunction)
Use this code when the patient presents with any of the following 1:
Symptoms of low testosterone: reduced energy, reduced endurance, diminished work/physical performance, fatigue, depression, reduced motivation, poor concentration, impaired memory, irritability, reduced sex drive, or erectile dysfunction 1
Physical signs: changes in body habitus, reduced virilization, gynecomastia, or testicular abnormalities 1
High-risk conditions (even without symptoms): unexplained anemia, bone density loss, diabetes, chemotherapy exposure, testicular radiation exposure, HIV/AIDS, chronic narcotic use, male infertility, pituitary dysfunction, or chronic corticosteroid use 1
When to Use Z13.29 (Screening Code)
Use this code when 1:
- The patient has no symptoms or signs of testosterone deficiency
- No high-risk conditions are present
- The patient is requesting routine screening without clinical indication
Additional Diagnostic Codes to Consider
Depending on the clinical presentation, consider these supplementary codes:
- N52.9 (Male erectile dysfunction, unspecified) - if erectile dysfunction is the primary complaint 1
- R53.83 (Other fatigue) - if fatigue is the presenting symptom 1
- F32.9 (Major depressive disorder, single episode, unspecified) - if depressive symptoms are prominent 1
- D64.9 (Anemia, unspecified) - if unexplained anemia is present 1
Clinical Caveat
The diagnosis of testosterone deficiency requires both low testosterone measurements AND clinical symptoms/signs 1. The American Urological Association defines low testosterone as consistently <300 ng/dL on at least two early morning measurements 1. Therefore, coding should reflect the clinical suspicion that justifies the laboratory testing, not merely the patient's request.
For men with erectile dysfunction specifically, testosterone measurement is recommended in all cases, particularly when PDE5 inhibitor therapy has failed 1. In HIV-infected men with fatigue, weight loss, loss of libido, erectile dysfunction, depressive symptoms, or reduced bone mineral density, morning serum total testosterone measurement should be obtained 1.