Hypogonadism does not have one universal ICD-10-CM code.
The correct diagnosis code depends on what the provider documents about the patient’s condition. The medical record may describe testicular hypofunction, ovarian failure, hypopituitarism, hypogonadotropic hypogonadism, postprocedural gonadal failure, or another endocrine disorder. Each situation can lead to a different coding pathway.
For many coding and billing situations, the most commonly encountered codes include E29.1 for testicular hypofunction, E28.39 for other primary ovarian failure, and E23.0 for hypopituitarism. The ICD-10-CM Index specifically maps male hypogonadism to E29.1, female hypogonadism to E28.39, hypogonadotropic hypogonadism to E23.0, ovarian primary hypogonadism to E28.39, and pituitary hypogonadism to E23.0.
That does not mean a coder can choose one of these codes simply because the patient’s testosterone or estrogen level is low.
The provider’s documented diagnosis remains central to code selection.
This guide explains the major ICD-10-CM codes associated with hypogonadism, how to distinguish primary from central hypogonadism, when E29.1, E28.39, or E23.0 may apply, what documentation supports the diagnosis, and which coding mistakes can create inaccurate insurance claims.
What Is the ICD-10 Code for Hypogonadism?
There is no single ICD-10-CM code for every form of hypogonadism.
The appropriate code depends on the documented type and underlying condition.
Common examples include:
| Documented condition | ICD-10-CM code | Code description |
| Male hypogonadism | E29.1 | Testicular hypofunction |
| Testicular hypogonadism | E29.1 | Testicular hypofunction |
| Female hypogonadism | E28.39 | Other primary ovarian failure |
| Primary ovarian hypogonadism | E28.39 | Other primary ovarian failure |
| Hypogonadotropic hypogonadism | E23.0 | Hypopituitarism |
| Pituitary hypogonadism | E23.0 | Hypopituitarism |
| Testicular dysfunction, unspecified | E29.9 | Testicular dysfunction, unspecified |
| Ovarian dysfunction, unspecified | E28.9 | Ovarian dysfunction, unspecified |
| Postprocedural testicular hypofunction | E89.5 | Postprocedural testicular hypofunction |
The table is a coding reference, not a replacement for the current ICD-10-CM Index and Tabular List.
The correct approach is to start with the provider’s documented diagnosis, locate that diagnostic term in the ICD-10-CM Index, and then verify the complete code and applicable instructions in the Tabular List.
The current FY 2027 ICD-10-CM release applies
The FY 2027 release, effective October 1, 2026 through September 30, 2027. CMS publishes the annual files because ICD-10-CM is updated on a fiscal-year basis.
What Is Hypogonadism?
Hypogonadism is a condition involving inadequate function of the gonads, which are the testes or ovaries.
The gonads have several important functions, including producing sex hormones and supporting reproductive function.
In males, the testes are responsible for testosterone production and sperm production.
In females, the ovaries produce hormones such as estrogen and progesterone and play a central role in reproductive function.
Hypogonadism can therefore present differently depending on the patient’s age, sex, underlying cause, and stage of reproductive development.
From a coding perspective, however, the most important question is not simply whether the patient has a hormone deficiency.
The important question is:
What diagnosis did the provider document?
A low hormone level can be part of the clinical evaluation, but the coder should not independently turn a laboratory result into a disease diagnosis.
Primary vs. Central Hypogonadism
Hypogonadism is often discussed in two broad categories: primary and central.
Understanding this distinction helps explain why different ICD-10-CM codes may apply.
What Is Primary Hypogonadism?
Primary hypogonadism occurs when the gonads themselves do not function adequately.
In a male patient, the problem involves testicular function.
In a female patient, the problem involves ovarian function.
Because the dysfunction originates at the level of the gonads, the ICD-10-CM classification can lead to codes in the E28 or E29 categories depending on the documented condition.
For example, the ICD-10-CM Index maps:
- Male hypogonadism to E29.1
- Testicular primary hypogonadism to E29.1
- Female hypogonadism to E28.39
- Ovarian primary hypogonadism to E28.39
What Is Central Hypogonadism?
Central hypogonadism involves dysfunction in the hypothalamic-pituitary system rather than primary failure of the gonads.
The pituitary gland produces hormones that regulate gonadal function. The hypothalamus also participates in this regulatory pathway.
When the hypothalamus or pituitary does not provide appropriate hormonal signaling, gonadal hormone production can be affected.
The ICD-10-CM Index maps hypogonadotropic hypogonadism and pituitary hypogonadism to E23.0, Hypopituitarism.
This is why E23.0 can appear in coding discussions about hypogonadism even though the code description itself is “Hypopituitarism.”
The code classification is based on the documented endocrine disorder.
E29.1: ICD-10 Code for Testicular Hypofunction
E29.1 is Testicular hypofunction.
It is one of the most important ICD-10-CM codes encountered when coding male hypogonadism.
The current FY 2027 classification places E29.1 under category E29, Testicular dysfunction. The code is a specific, billable diagnosis code. Its inclusion terms include testicular hypogonadism NOS and defective biosynthesis of testicular androgen NOS.
The code should be selected when the documentation supports testicular hypofunction or another diagnostic term classified to E29.1.
The current classification includes terms such as:
- Testicular hypogonadism NOS
- Defective biosynthesis of testicular androgen NOS
- 5-alpha-reductase deficiency with male pseudohermaphroditism
The exact coding situation should still be evaluated against the current Tabular List and the complete medical record.
E29.1 and Male Hypogonadism
The ICD-10-CM Index specifically maps male hypogonadism to E29.1.
This makes E29.1 an important code when a provider documents male hypogonadism without documentation that redirects the condition to another classification.
For example, if the provider’s assessment states:
“Male hypogonadism due to testicular dysfunction.”
E29.1 may represent the documented diagnosis.
However, if the provider documents hypogonadotropic hypogonadism due to pituitary dysfunction, the coding pathway is different.
That is why the phrase “hypogonadism” alone should not cause the coder to stop at E29.1.
| E29.1 Is Not a Universal Code for Every Male Patient With Low Testosterone This is an important distinction. A patient can have a low testosterone result without the provider documenting testicular hypofunction. The coder should not assume: |
Low testosterone = E29.1
That equation is too simplistic.
The laboratory result may support the provider’s clinical assessment, but diagnosis coding should be based on the provider’s documented condition and the applicable coding guidelines.
For example, if a provider documents:
“Low testosterone level. Additional evaluation planned. No diagnosis of hypogonadism established.”
The coder should not automatically convert the laboratory finding into E29.1.
By contrast, if the provider documents:
“Testicular hypofunction causing male hypogonadism.”
E29.1 may be appropriate.
The distinction protects against coding a condition that the provider has not actually diagnosed.
E29.1 Excludes Postprocedural Testicular Hypofunction
The current E29.1 classification has an Excludes1 note for postprocedural testicular hypofunction, which is classified to E89.5.
This is a useful example of why coders should not select a code based only on the broad diagnostic concept.
A patient may have impaired testicular function, but the cause of that impairment can change the code.
If the documentation establishes that the condition is postprocedural, the coder should review E89.5 rather than reporting E29.1.
E28.39: Other Primary Ovarian Failure
E28.39 is Other primary ovarian failure.
This code is relevant to female hypogonadism when the documented diagnosis falls within this classification.
The ICD-10-CM Index maps female hypogonadism and ovarian primary hypogonadism to E28.39.
This is important because some online resources incorrectly simplify female hypogonadism into a generic ovarian dysfunction code.
The provider’s exact diagnosis matters.
Female Hypogonadism and E28.39
When a provider documents female hypogonadism and the diagnosis is classified to primary ovarian failure, E28.39 may be the appropriate ICD-10-CM code.
The coder should still verify the current code description and applicable instructions for the date of service.
The patient’s symptoms alone should not determine the code.
For example, irregular menstruation, infertility, hot flashes, or low estrogen may occur in multiple conditions. Those symptoms do not independently establish primary ovarian failure.
The provider must document the diagnosis that supports the selected code.
E28.39 vs. Other Ovarian Codes
Ovarian disorders are not all coded to E28.39.
The E28 category contains multiple ovarian dysfunction classifications.
A patient may have:
- Primary ovarian failure
- Other ovarian dysfunction
- Ovarian dysfunction, unspecified
- Polycystic ovarian syndrome
- Other specified ovarian conditions
The coder should therefore avoid treating E28.39 as a universal “female hypogonadism” code without reviewing the documented diagnosis.
This is particularly important when the record contains a condition with a more specific ICD-10-CM classification.
E23.0: ICD-10 Code for Hypogonadotropic Hypogonadism
E23.0 is Hypopituitarism.
The code is important in hypogonadism coding because the ICD-10-CM classification includes hypogonadotropic hypogonadism as an inclusion term under E23.0. The current FY 2027 code information also identifies pituitary insufficiency, isolated gonadotropin deficiency, and other pituitary conditions within the scope of the code.
The ICD-10-CM Index maps:
- Hypogonadotropic hypogonadism → E23.0
- Pituitary hypogonadism → E23.0
This makes E23.0 particularly relevant when the provider documents central or pituitary-related hypogonadism.
The code description does not say “hypogonadism.”
It says:
Hypopituitarism.
A coder who searches only for the word “hypogonadism” may not understand why E23.0 appears in the Index.
The Index provides the bridge between the clinical diagnostic term and the classification.
When the provider documents hypogonadotropic hypogonadism, the Index directs the coder to E23.0.
This is an excellent example of why code selection should involve both the Alphabetic Index and Tabular List.
E23.0 and Pituitary Dysfunction
The pituitary gland influences multiple endocrine systems.
Hypopituitarism can therefore affect more than reproductive hormones.
A patient with pituitary dysfunction may have deficiencies involving growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, or gonadotropins.
The exact clinical presentation depends on the hormones affected.
For coding, the provider’s documented diagnosis remains the starting point.
If the record documents hypopituitarism with hypogonadotropic hypogonadism, E23.0 can represent the pituitary disorder.
If another associated endocrine condition is documented and separately reportable, additional coding may be required according to the applicable classification and guidelines.
E23.1: Drug-Induced Hypopituitarism
E23.1 represents Drug-induced hypopituitarism.
This code should not be treated as a generic code for every patient taking medication who also has hypogonadism.
The documentation needs to establish the drug-induced pituitary condition.
If the provider documents drug-induced hypopituitarism, the coder should review E23.1 and the applicable adverse-effect or external-cause coding instructions.
The current E23.0 information also distinguishes itself from drug-induced hypopituitarism by listing E23.1 as a related code.
The underlying cause matters.
E23.3: Hypothalamic Dysfunction
E23.3 is Hypothalamic dysfunction, not elsewhere classified.
The hypothalamus plays a major role in regulating pituitary function and therefore can be involved in central hypogonadism.
However, the presence of a hypothalamic disorder does not mean the coder should automatically assign E23.3 to every case described as central hypogonadism.
The provider’s documentation should establish the hypothalamic condition.
When the documented diagnosis is specifically hypogonadotropic hypogonadism, the ICD-10-CM Index directs the coder to E23.0.
This distinction prevents the coder from replacing a documented diagnostic term with a presumed underlying cause.
E29.9: Testicular Dysfunction, Unspecified
E29.9 is Testicular dysfunction, unspecified.
This code belongs to the E29 category of testicular dysfunction.
It should not automatically replace E29.1 simply because the medical record lacks a detailed explanation of the cause.
The coder should first determine whether the provider documented testicular hypofunction.
If the provider specifically documents testicular hypofunction or testicular hypogonadism NOS, E29.1 may be appropriate.
If the documentation instead states only unspecified testicular dysfunction, E29.9 may be more appropriate.
The wording of the provider’s diagnosis matters.
E28.9: Ovarian Dysfunction, Unspecified
E28.9 is Ovarian dysfunction, unspecified.
This code is different from E28.39, Other primary ovarian failure.
If the provider documents a specific diagnosis of primary ovarian failure, E28.39 may apply.
If the provider documents only ovarian dysfunction without further specification, E28.9 may be considered.
Again, the coder should not add specificity that the medical record does not support.
At the same time, the coder should not choose an unspecified code when the provider has already documented a more specific condition.
E89.5: Postprocedural Testicular Hypofunction
A patient may develop testicular hypofunction following a procedure.
The ICD-10-CM classification directs postprocedural testicular hypofunction to E89.5, rather than E29.1. The Excludes1 note under E29.1 reinforces this distinction.
This is a good example of why the cause of a condition matters.
The clinical concept may still involve reduced testicular function, but the coding classification changes because the condition is postprocedural.
Coders should review the operative history and provider documentation when the medical record indicates that gonadal dysfunction followed a procedure.
Hypogonadism vs. Low Testosterone
These terms should not be treated as interchangeable for coding purposes.
“Low testosterone” can describe a laboratory finding.
“Hypogonadism” is a clinical diagnosis.
A patient may have a low testosterone measurement during evaluation without having a documented diagnosis of hypogonadism.
The provider may order repeat testing, assess symptoms, review medications, investigate other causes, or determine that the laboratory finding does not establish a disease.
Therefore, the coding decision should follow the provider’s documented diagnosis.
Why This Matters for Billing
Medical claims use diagnosis codes to communicate the conditions relevant to the services billed.
If the claim reports E29.1, the medical record should support the diagnosis represented by E29.1.
A laboratory value by itself does not automatically establish that diagnosis.
This is particularly important when testosterone replacement therapy or hormone-related laboratory testing is involved.
Payer policies may impose additional medical-necessity requirements, and those policies can vary.
For example, a current Aetna policy lists E29.1 for testicular hypofunction in connection with certain testosterone cypionate coverage criteria while specifically distinguishing age-related or late-onset hypogonadism from covered indications under that policy. This illustrates why a diagnosis code and a payer’s coverage policy are related but not identical questions.
Does Testosterone Therapy Determine the ICD-10 Code?
No.
The treatment does not automatically determine the diagnosis code.
A patient receiving testosterone could have different documented indications.
For example, the provider may document:
- Testicular hypofunction
- Hypogonadotropic hypogonadism
- Hypopituitarism
- Another endocrine disorder
- A condition for which a particular payer has different coverage rules
The coder should code the documented diagnosis rather than selecting the diagnosis that appears most commonly associated with the medication.
This distinction becomes especially important when payer policies have coverage limitations.
Documentation Requirements for Hypogonadism Coding
Strong documentation gives the coder a clear path from the clinical assessment to the ICD-10-CM code.
A record may include:
- Provider’s diagnosis
- Relevant symptoms
- Hormone laboratory findings
- Relevant medical history
- Physical examination findings
- Etiology when known
- Gonadal or pituitary findings
- Relevant imaging
- Treatment history
- Response to treatment
- Follow-up plan
- Associated endocrine disorders
The exact documentation required depends on the clinical situation and the service being billed.
The provider should document the condition that was actually evaluated and treated.
The coder should not create a diagnosis merely because certain laboratory results or symptoms appear in the chart.
Hypogonadism and Infertility Coding
Hypogonadism and infertility can occur together, but they are not interchangeable diagnoses.
A patient may receive an infertility evaluation because of an endocrine disorder.
The medical record may support more than one diagnosis depending on what the provider documents and the coding rules that apply.
The ICD-10-CM classification also contains specific infertility codes and relationships with endocrine disorders. For example, current coding references identify hypopituitarism as an associated condition in the context of female infertility.
The coder should therefore avoid assuming that hypogonadism automatically replaces infertility coding or vice versa.
Review the reason for the encounter and the provider’s documented assessment.
Hypogonadism and Erectile Dysfunction
Erectile dysfunction may occur in patients with male hypogonadism, but it is not synonymous with hypogonadism.
A patient may have erectile dysfunction caused by vascular, neurologic, medication-related, psychological, endocrine, or other factors.
If the provider documents both hypogonadism and erectile dysfunction and both are relevant to the encounter, the coding rules should be reviewed to determine whether both conditions should be reported.
Do not infer hypogonadism from erectile dysfunction alone.
Likewise, do not assume that every patient with hypogonadism has erectile dysfunction.
Hypogonadism and Menopause
Female hypogonadism and menopause should not automatically be treated as identical diagnoses.
The medical record may describe menopause, premature ovarian failure, primary ovarian failure, another ovarian disorder, or an endocrine condition affecting reproductive function.
The correct ICD-10-CM classification depends on the provider’s diagnosis.
This is another reason a general statement such as “female hypogonadism equals E28.39” can be misleading without context.
E28.39 is specifically Other primary ovarian failure, not a universal code for every female hormonal complaint.
Hypogonadism in Children and Adolescents
Hypogonadism can also be evaluated in pediatric and adolescent patients.
The coding considerations may be more complex because the record may involve delayed puberty, congenital conditions, disorders of sexual development, pituitary disease, genetic disorders, or other endocrine conditions.
The presence of delayed puberty does not automatically establish hypogonadism.
Likewise, a developmental delay should not be converted into an endocrine diagnosis without provider documentation.
Pediatric coding requires careful review of the documented diagnosis and applicable ICD-10-CM classification.
E30.0 Delayed Puberty Is Not a Hypogonadism Code
When the pediatric record documents delayed puberty, the code is E30.0, Delayed puberty. Constitutional delay is a diagnosis of exclusion and stays at E30.0 until the provider documents a gonadal or pituitary cause. If the provider later documents hypogonadotropic hypogonadism or a congenital syndrome, the code moves to E23.0 or the Q-code, and E30.0 is no longer reported for that condition. The pediatric endocrinology claim follows the same rule as the adult claim: the documented diagnosis, not the developmental finding, drives the code.
Common Hypogonadism Coding Mistakes
Treating E29.1 as the code for every form of hypogonadism
E29.1 represents testicular hypofunction.
It is appropriate for documented conditions classified there, including male hypogonadism and testicular hypogonadism NOS, but it is not the universal code for central or female hypogonadism.
Using E28.39 for every female hormone disorder
E28.39 represents other primary ovarian failure.
It should not automatically be assigned to every patient with low estrogen, irregular menstruation, infertility, or menopausal symptoms.
Missing E23.0 for hypogonadotropic hypogonadism
The ICD-10-CM Index maps hypogonadotropic hypogonadism to E23.0.
A coder who uses E29.1 for every male hypogonadism diagnosis could therefore miss the classification for central or pituitary-related hypogonadism.
Coding from laboratory values alone
A low testosterone or estrogen result does not automatically establish a diagnosis.
The provider’s documentation should support the condition being coded.
Ignoring postprocedural conditions
Postprocedural testicular hypofunction is classified to E89.5 rather than E29.1.
Confusing diagnosis coding with payer coverage
A code can accurately describe a patient’s condition while a payer still denies a particular service because the payer’s medical policy has additional requirements.
Using an outdated code set
ICD-10-CM is updated annually.
The current FY 2027 files apply beginning October 1, 2026. CMS makes the annual files available through its ICD-10 resource page.
Coding Klinefelter Syndrome to E29.1
Several online references place Klinefelter syndrome under E29.1. It belongs in category Q98, Other sex chromosome abnormalities, male phenotype, with Q98.4 for Klinefelter syndrome, unspecified. Testicular hypofunction that the provider separately documents as a manifestation may be reported alongside the Q-code according to the applicable guideline.
Treating G11.5 as a Hypogonadism Code
G11.5 describes 4H syndrome (hypomyelination, hypogonadotropic hypogonadism, hypodontia), a rare genetic leukodystrophy. It is a syndrome code. It is not an alternative to E23.0 for ordinary hypogonadotropic hypogonadism and should not appear on a claim unless the provider documents the syndrome.
Using Personal History Codes for an Active Condition
Z87.438, Personal history of other diseases of the male genital organs, and Z87.42, Personal history of other diseases of the female genital tract, apply only when the provider documents that the condition is resolved and no longer under treatment. A patient on ongoing testosterone therapy has an active diagnosis and does not get a Z87 code.
Denial Codes That Follow Hypogonadism Coding Errors
| Denial (CARC) | Typical trigger on a hypogonadism claim | Prevention |
| CO-50, not medically necessary | Testosterone lab or J-code billed with R79.89 or an unspecified code the payer does not cover | Match the covered diagnosis list before submission |
| CO-11, diagnosis inconsistent with procedure | Female diagnosis (E28.39) on a claim with a male-only procedure or drug | Sex-edit scrub before submission |
| CO-197, precertification absent | Testosterone therapy under Medicare Advantage or commercial plans requiring prior authorization | Authorization on file before the first injection |
| CO-4, procedure code inconsistent with modifier | 96372 billed without the drug line, or with the wrong units on the J-code | Unit and pairing check on every injection claim |
| CO-96 or PR-96, non-covered | Pellet therapy (S0189, 11980) under Medicare, or age-related hypogonadism excluded by plan policy | Verify benefits and policy exclusions at intake |
UControl Urology and Endocrinology Billing team tracks these five denials by payer for every endocrine and urology client and works the root cause back to the coding step that produced it.
How to Select the Correct Hypogonadism ICD-10 Code
A consistent workflow can reduce coding errors.
Read the provider’s final assessment
Start with the diagnosis, not the laboratory result.
Look for terms such as:
- Male hypogonadism
- Testicular hypofunction
- Female hypogonadism
- Primary ovarian failure
- Hypogonadotropic hypogonadism
- Hypopituitarism
- Postprocedural testicular hypofunction
Identify the anatomical or endocrine source
Determine whether the documented condition involves:
- Testes
- Ovaries
- Pituitary gland
- Hypothalamus
- Postprocedural endocrine dysfunction
- Another documented cause
Search the ICD-10-CM Index
Use the exact diagnostic term documented by the provider.
For example, the Index provides specific directions for male hypogonadism, female hypogonadism, hypogonadotropic hypogonadism, ovarian hypogonadism, and pituitary hypogonadism.
Verify the code in the Tabular List
The Index is not the final step.
Review the complete Tabular List entry for:
- Code description
- Inclusion terms
- Excludes1 notes
- Excludes2 notes
- Code-first instructions
- Use-additional-code instructions
- Other applicable notes
Check the date of service
Verify that the code belongs to the ICD-10-CM release applicable to the encounter.
The FY 2027 release applies to encounters from October 1, 2026 through September 30, 2027.
Review payer policy separately
If the claim involves testosterone replacement, hormone testing, infertility services, or another treatment subject to medical-necessity criteria, review the payer’s current policy.
Do not assume that the ICD-10-CM code itself establishes coverage.
Which Specialties Bill Hypogonadism Codes Most Often
Endocrinology practices carry the central hypogonadism and pituitary cases and report E23.0 more than any other specialty. Urology and men’s health clinics carry the E29.1 and R79.89 volume, along with almost all of the testosterone replacement therapy claims. Primary care and internal medicine practices see the first low draw and are the most likely to code R79.89 correctly or to miscode it as E29.1. OBGYN reports the E28 series, and pediatric endocrinology reports E30.0 and the Q-codes. Telehealth TRT clinics have become a fast-growing source of E29.1 claims and of payer scrutiny; in July 2026 the Department of Defense announced annual testosterone deficiency screening for active-duty service members aged 30 and over, which will move more of these encounters into the civilian claim stream over the next year.
UControl Billing supports each of these specialties with coders who work the same accounts every week, so the endocrine claim that needs D35.2 sequenced before E23.0 is coded the same way every time.
How UControl Billing Codes Hypogonadism Claims
There is no single ICD-10-CM code for hypogonadism. E29.1 covers documented testicular hypofunction, E28.39 covers other primary ovarian failure, E23.0 covers hypopituitarism including hypogonadotropic hypogonadism, and R79.89 covers the low testosterone result that has not become a diagnosis yet. The coder starts with the provider’s assessment, reads the cause, checks the Index, verifies the Tabular List, confirms the date of service against the FY 2027 files, and reads the payer policy separately.
That is the workflow UControl Billing runs on every endocrine, urology and primary care claim. Coders certified through AAPC and AHIMA review the diagnosis against the documentation before the claim is scrubbed, testosterone labs are checked against the MAC’s covered-diagnosis list, and TRT authorizations are on file before the first injection is billed. Practices that want that process on their own hypogonadism claims can request a free coding audit of their last 30 days of endocrine and urology encounters.
Frequently Asked Questions
What is the ICD-10 code for female hypogonadism?
The ICD-10-CM Index maps female hypogonadism to E28.39, Other primary ovarian failure.
What is the ICD-10 code for hypogonadotropic hypogonadism?
The ICD-10-CM Index maps hypogonadotropic hypogonadism to E23.0, Hypopituitarism. Hypogonadotropic hypogonadism is also listed as an inclusion term under E23.0.
What is the ICD-10 code for pituitary hypogonadism?
The ICD-10-CM Index maps pituitary hypogonadism to E23.0, Hypopituitarism.
Is E29.1 the code for low testosterone?
Not automatically.
E29.1 represents testicular hypofunction. A low testosterone laboratory result alone does not necessarily establish that diagnosis.
Can E29.1 be used for every male patient receiving testosterone?
No.
The diagnosis must be supported by provider documentation, and payer coverage can impose additional requirements.
Is E28.39 the same as menopause?
No.
E28.39 represents other primary ovarian failure. Menopause and other ovarian or reproductive conditions may have different classifications.
What is E29.9?
E29.9 is Testicular dysfunction, unspecified.
It should not automatically replace E29.1 when the provider has specifically documented testicular hypofunction.
Can hypogonadism and infertility be coded together?
They can potentially both be reportable when supported by the documentation and applicable coding rules. They represent different clinical concepts, so one should not automatically be substituted for the other.
Does ICD-10-CM require two testosterone tests before E29.1 can be reported?
ICD-10-CM itself should not be confused with clinical diagnostic criteria or payer coverage requirements. If a payer requires specific laboratory documentation for treatment coverage, that requirement is separate from the basic ICD-10-CM code description.
Does the ICD-10 code guarantee reimbursement?
No.
The diagnosis code is only one component of a claim. Coverage, medical necessity, documentation, patient benefits, provider status, procedure or drug codes, authorization requirements, and payer policy can all affect payment.
What is the ICD-10 code for low testosterone? When the provider documents a low testosterone result without a diagnosis of hypogonadism, the encounter is coded to the finding, R79.89, Other specified abnormal findings of blood chemistry. E29.1 applies only after the provider documents testicular hypofunction or male hypogonadism.
Is E29.1 a billable code?
Yes. E29.1 is a complete, specific code with no further subdivision and can be reported on a claim when the documentation supports it.
What is the ICD-10 code for Klinefelter syndrome?
Q98.4, Klinefelter syndrome, unspecified, or the specific Q98.0 to Q98.3 code when the karyotype is documented. E29.1 is not the code for Klinefelter syndrome.
What ICD-10 code is used for testosterone replacement therapy follow-up?
The underlying diagnosis, such as E29.1 or E23.0, followed by Z79.890, Hormone replacement therapy, as an additional code for the long-term use of the drug [VERIFY].
What is the ICD-10 code for premature ovarian failure?
E28.310 for symptomatic premature menopause and E28.319 for asymptomatic premature menopause. E28.39 is the residual code for other primary ovarian failure.
Does Medicare cover testosterone testing with E29.1?
Coverage depends on the Medicare Administrative Contractor’s local coverage determination, which lists covered diagnoses and frequency limits. E29.1 appears on most covered lists; R79.89 and unspecified codes may not.
