What ICD‑10 code should I use to order serum testosterone testing for a male patient being evaluated for low testosterone (hypogonadism)?

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ICD-10 Code for Ordering Testosterone Labs

Use ICD-10 code E29.1 (Testicular hypofunction) as the primary diagnostic code when ordering serum testosterone testing for suspected male hypogonadism. 1

Primary Diagnostic Code

  • E29.1 (Testicular hypofunction) is the appropriate code when clinical suspicion of testosterone deficiency exists based on symptoms, physical signs, or high-risk conditions 1

When to Use E29.1

Symptom-Based Indications

  • Reduced libido or erectile dysfunction 1
  • Fatigue, reduced energy, or diminished work/physical performance 1
  • Depression, reduced motivation, poor concentration, or impaired memory 1
  • Irritability or mood changes 1

Physical Examination Findings

  • Changes in body habitus (increased adiposity, reduced muscle mass) 1
  • Reduced virilization (decreased body hair in androgen-dependent areas) 1
  • Gynecomastia 1
  • Testicular abnormalities (small size, abnormal consistency) 1

High-Risk Conditions (Even Without Symptoms)

The AUA recommends measuring testosterone in men with these conditions even in the absence of classic hypogonadal symptoms 2:

  • Unexplained anemia 2, 1
  • Decreased bone mineral density or osteoporosis 2, 1
  • Type 2 diabetes mellitus 2, 1
  • HIV/AIDS 2, 1
  • History of chemotherapy exposure 2, 1
  • Direct or scatter radiation therapy to the testes 2, 1
  • Chronic narcotic use 2, 1
  • Male infertility 2, 1
  • Pituitary disorders 2, 1
  • Chronic corticosteroid use 2, 1

Supplementary Codes to Add

When specific symptoms dominate the clinical presentation, add these supplementary codes alongside E29.1:

  • 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

Critical Testing Requirements

  • Diagnosis of testosterone deficiency requires both low testosterone measurements (<300 ng/dL on at least two early morning measurements between 8-10 AM) and clinical symptoms or signs 1, 2
  • The code E29.1 justifies ordering the initial testosterone panel even before biochemical confirmation, as long as clinical suspicion exists 1
  • Testosterone should be measured in all men with erectile dysfunction, particularly when PDE5 inhibitor therapy has failed 1

Common Pitfall to Avoid

  • Do not wait for biochemical confirmation before using E29.1 – the code is appropriate when ordering the initial diagnostic testosterone testing based on clinical suspicion from symptoms, signs, or high-risk conditions 1
  • The code supports ordering the lab work needed to establish the diagnosis, not just documenting an already-confirmed diagnosis 1

References

Guideline

Testosterone Level Testing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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