Summary & Overview
CPT 84270: Sex Hormone Binding Globulin (SHBG) Test
CPT code 84270 represents a laboratory assay that measures sex hormone binding globulin (SHBG) in blood. SHBG testing is used in endocrine and reproductive medicine to help interpret levels of circulating sex steroids and assess conditions such as androgen excess, hypogonadism, or disorders of liver function and metabolism. Nationally, SHBG measurement is a commonly ordered diagnostic test that supports clinical decision-making in primary care, endocrinology, and gynecology.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for SHBG testing, standard sites of service, and which payer categories typically cover or process claims for this laboratory service. The publication outlines typical billing considerations and common modifiers associated with laboratory testing in general. It also highlights benchmarking elements and policy considerations relevant to coverage and claims processing for clinical laboratory services.
This summary provides clinicians, billing professionals, and policy analysts with the clinical framing and payer context needed to understand where CPT code 84270 fits into diagnostic pathways and payer workflows. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 84270 describes a laboratory test to measure sex hormone binding globulin (SHBG), typically performed on a patient blood specimen. The service is a clinical laboratory diagnostic assay used to evaluate circulating levels of SHBG, which can inform interpretation of sex steroid hormone availability and endocrine function.
Service type: Clinical laboratory test
Typical site of service: Clinical laboratory or hospital laboratory, using blood specimens collected in outpatient or inpatient settings
Clinical & Coding Specifications
Clinical Context
A 45-year-old person assigned female at birth presents to endocrinology with symptoms of unexplained hirsutism, irregular menses, and infertility. The clinician orders laboratory evaluation including a 84270 sex hormone binding globulin (SHBG) assay on a venous blood specimen to help differentiate hyperandrogenic states (for example, polycystic ovary syndrome, androgen-secreting tumor, or insulin resistance) and to interpret total testosterone values. The typical workflow: outpatient visit → venipuncture at clinic or centralized phlebotomy center → specimen sent to clinical laboratory → analytic measurement of SHBG using immunoassay or other validated method → result reported to ordering clinician for integration with other hormone tests (total testosterone, free androgen index, estradiol) to guide diagnosis and management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the professional (interpretive) component is billed separately from the technical component for the laboratory service. |
TC | Technical component |