Testosterone Level Testing Guidelines

Clinical Context for Code Selection

The American Urological Association recommends using 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, such as reduced energy, reduced endurance, diminished work/physical performance, fatigue, depression, reduced motivation, poor concentration, impaired memory, irritability, reduced sex drive, or erectile dysfunction 1, 2
The American Urological Association suggests considering physical signs, such as changes in body habitus, reduced virilization, gynecomastia, or testicular abnormalities, when selecting the ICD-10 code E29.1 (Testicular hypofunction) 1
High-risk conditions, including unexplained anemia, bone density loss, diabetes, chemotherapy exposure, testicular radiation exposure, HIV/AIDS, chronic narcotic use, male infertility, pituitary dysfunction, or chronic corticosteroid use, should be considered when selecting the ICD-10 code E29.1 (Testicular hypofunction), even in the absence of symptoms 1, 2, 3

The American Urological Association recommends using supplementary code N52.9 (Male erectile dysfunction, unspecified) if erectile dysfunction is the primary complaint 4
The American Urological Association suggests using supplementary code R53.83 (Other fatigue) if fatigue is the presenting symptom 1
The American Urological Association recommends using supplementary code F32.9 (Major depressive disorder, single episode, unspecified) if depressive symptoms are prominent 1
The American Urological Association suggests using supplementary code D64.9 (Anemia, unspecified) if unexplained anemia is present 1, 2

The American Urological Association defines low testosterone as consistently <300 ng/dL on at least two early morning measurements, and diagnosis of testosterone deficiency requires both low testosterone measurements AND clinical symptoms/signs 1, 3
The American Urological Association recommends testosterone measurement in all cases of erectile dysfunction, particularly when PDE5 inhibitor therapy has failed 4
The Centers for Disease Control and Prevention suggests obtaining morning serum total testosterone measurement in HIV-infected men with fatigue, weight loss, loss of libido, erectile dysfunction, depressive symptoms, or reduced bone mineral density 5

The American Diabetes Association recommends measuring morning total testosterone using an accurate and reliable assay in men with diabetes who have symptoms or signs of low testosterone 6
The American Urological Association suggests that all men with erectile dysfunction should have testosterone measured, particularly when PDE5 inhibitor therapy has failed, using code E29.1 with supplementary N52.9 7
The European Association for the Study of the Liver recommends measuring serum testosterone/SHBG/LH/FSH in the morning in men with chronic liver disease being evaluated for osteoporosis, using code E29.1 8

Men with diabetes who have symptoms or signs of low testosterone should have morning total testosterone measured using an accurate and reliable assay, according to the American Association of Clinical Endocrinologists 6
HIV-infected men with fatigue, weight loss, loss of libido, erectile dysfunction, depressive symptoms, or reduced bone mineral density should have morning serum total testosterone measured, using code E29.1 with appropriate supplementary codes, as recommended by the Infectious Diseases Society of America 7