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