The Current Procedural Terminology (CPT) code set is a medical code set used to report medical, surgical, and diagnostic procedures and services to entities such as physicians, health insurance companies, and accreditation organizations.
When it comes to hormone replacement therapy (HRT), there are several CPT codes that may apply depending on the specific services provided. Some common CPT codes related to HRT include:
- 963XX: Hormone replacement therapy services including but not limited to estrogen, testosterone, progesterone, dehydroepiandrosterone injections. May include counseling, assessment, and adjustment of dosage.
- 90471: Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); one vaccine (single or combination vaccine/toxoid)
- 96372: Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
- 36415: Routine venipuncture for collection of specimen(s)
- 80048: Basic metabolic panel
- 80053: Comprehensive metabolic panel
- 84439: Thyroid stimulating hormone (TSH)
- 84443: Thyroid panel, includes TSH, total thyroxine, and triiodothyronine uptake
The specific CPT code(s) used may vary depending on:
- Type of hormone therapy: estrogen, testosterone, progesterone, combination therapy
- Route of administration: oral, transdermal, injection, implant
- Lab testing and monitoring: blood tests to check hormone, cholesterol, or glucose levels
- Complexity: new patient versus established patient, initial consultation versus follow-up
When billing for HRT services, it is important to select the CPT code(s) that most accurately describe the services rendered. Using unspecified or inaccurate codes can lead to delays or denial of claims.
Some tips for accurate CPT coding for HRT:
- Use a medical decision making code for the initial consultation and assessment
- Use injection administration codes for hormonal injections
- Use medication therapy management codes for substantial counseling or dosage adjustments
- Bill lab services like blood tests separately using the appropriate CPT codes
If you have any questions about what CPT codes should be used for your specific HRT treatment plan, consult your clinical billing staff or the coding experts at
Hormone Harmony Clinic. Our knowledgeable coding team is happy to provide guidance to ensure proper coding and maximize reimbursement.
As a leading hormone therapy provider,
Hormone Harmony Clinic offers both male and female hormone replacement therapy to help patients experiencing issues like
menopause or low testosterone. Our compassionate physicians create customized treatment plans to meet each patient's unique needs and health goals. Schedule a consultation at Hormone Harmony Clinic today to find out if hormone therapy is right for you!
