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The CPT® Code 84270 refers to the measurement of sex hormone binding globulin (SHBG) levels through a blood test. SHBG is a glycoprotein that plays a crucial role in the regulation of sex hormones, specifically testosterone and estradiol, by binding to them in the bloodstream. This binding affects the availability of these hormones to tissues and can influence various physiological processes. The measurement of SHBG is often conducted alongside a total testosterone test, identified by CPT® Code 84403, to provide a comprehensive assessment of hormonal balance. In men, low SHBG levels are typically associated with reduced testosterone levels, which can lead to conditions such as infertility and erectile dysfunction. Conversely, in women, elevated SHBG levels may indicate underlying health issues, including amenorrhea, infertility, acne, hirsutism, and polycystic ovarian syndrome (PCOS). The test is performed by obtaining a blood sample through venipuncture, which is a separately reportable procedure. The serum or plasma obtained from the blood sample is then analyzed using a quantitative electrochemiluminescent immunoassay, a sensitive and specific method for measuring SHBG concentrations in the laboratory.
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The measurement of sex hormone binding globulin (SHBG) levels is indicated for various clinical scenarios, particularly when assessing hormonal imbalances or related conditions. The following are the specific indications for performing this test:
The procedure for measuring sex hormone binding globulin (SHBG) levels involves several key steps, which are outlined below:
After the procedure, patients may be advised to resume their normal activities, as there are typically no significant restrictions following a blood draw. However, it is common for patients to experience minor discomfort or bruising at the venipuncture site, which usually resolves quickly. The healthcare provider will discuss the results with the patient once they are available, and any necessary follow-up actions or additional testing will be determined based on the findings. It is important for patients to understand the implications of their SHBG levels and how they relate to their overall health and any symptoms they may be experiencing.
| Short Descr | ASSAY OF SEX HORMONE GLOBUL | Medium Descr | ASSAY OF SEX HORMONE BINDING GLOBULIN | Long Descr | Sex hormone binding globulin (SHBG) | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | CLIA Waived (QW) | No | APC Status Indicator | Conditionally packaged laboratory tests | Type of Service (TOS) | 5 - Diagnostic Laboratory | Berenson-Eggers TOS (BETOS) | T1H - Lab tests - other (non-Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 233 - Laboratory - Chemistry and Hematology |
| 90 | Reference (outside) laboratory: when laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number. | GA | Waiver of liability statement issued as required by payer policy, individual case | GZ | Item or service expected to be denied as not reasonable and necessary | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 91 | Repeat clinical diagnostic laboratory test: in the course of treatment of the patient, it may be necessary to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results. under these circumstances, the laboratory test performed can be identified by its usual procedure number and the addition of modifier 91. note: this modifier may not be used when tests are rerun to confirm initial results; due to testing problems with specimens or equipment; or for any other reason when a normal, one-time, reportable result is all that is required. this modifier may not be used when other code(s) describe a series of test results (eg, glucose tolerance tests, evocative/suppression testing). this modifier may only be used for laboratory test(s) performed more than once on the same day on the same patient. | GW | Service not related to the hospice patient's terminal condition | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | AY | Item or service furnished to an esrd patient that is not for the treatment of esrd | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | KX | Requirements specified in the medical policy have been met | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q4 | Service for ordering/referring physician qualifies as a service exemption | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| 1993-01-01 | Added | First appearance in code book in 1993. |
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