Billing and Coding: Treatment of Males with Low Testosterone

Medicare Coverage Database article A57615

Article

Contractor: Noridian Healthcare Solutions, LLC
States (A/B MAC): AK, AS, AZ, CA, GU, HI, ID, MP, MT, ND, NV, OR, SD, UT, WA, WY
Effective: Oct 16, 2025
Contractor numbers: 01111, 01112, 01182, 01211, 01212, 01311, 01312, 01911, 02101, 02102, 02201, 02202, 02301, 02302, 02401, 02402, 03101, 03102, 03201, 03202, 03301, 03302, 03401, 03402, 03501, 03502, 03601, 03602
Official article: A57615 on cms.gov (version 6)

Read the article's coding instructions on CMS — which codes go together, documentation, and frequency limits — before billing. CodeRx lists the codes, not the instructions.

Drug codes in this article

HCPCS Level II drug codes the article lists (other codes it lists are not shown).

Covered ICD-10-CM codes (11)

Diagnosis codes the article lists as supporting medical necessity, grouped as in the article, with CMS's descriptions.

D35.2Benign neoplasm of pituitary gland
D44.3Neoplasm of uncertain behavior of pituitary gland
E23.0Hypopituitarism
E23.1Drug-induced hypopituitarism
E23.3Hypothalamic dysfunction, not elsewhere classified
E23.6Other disorders of pituitary gland
E23.7Disorder of pituitary gland, unspecified
E29.1Testicular hypofunction
E29.8Other testicular dysfunction
E89.5Postprocedural testicular hypofunction
N50.89Other specified disorders of the male genital organs

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