Summary & Overview
HCPCS S3650: Saliva Test for Hormone Levels During Menopause
HCPCS Level II code S3650 identifies a saliva-based hormone test used during menopause to assess hormone levels. As an outpatient diagnostic laboratory service, this code captures noninvasive specimen collection and laboratory analysis intended to evaluate menopausal hormonal status. Nationally, accurate coding for such diagnostic tests matters for clinical documentation, claims processing, and appropriate utilization tracking as interest in less-invasive hormone testing grows.
Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on clinical utility, typical sites of service, and how this code is categorized within HCPCS Level II. The publication provides benchmarks and policy-relevant information where available, highlights payer coverage considerations, and outlines common billing contexts for saliva hormone testing during menopause.
The content is intended for clinicians, billing professionals, and policy analysts seeking a concise reference on HCPCS Level II code S3650, including what the code represents, its clinical context, and areas to review for payer-specific coverage and claims adjudication. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code S3650 describes a saliva test for hormone levels during menopause. The service type is diagnostic laboratory testing for hormonal assessment, performed to evaluate menopausal status or related hormonal changes. The typical site of service is outpatient clinical settings or diagnostic laboratories, including physician offices and outpatient lab collection sites where saliva specimens are obtained and sent for analysis.
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Clinical & Coding Specifications
Clinical Context
A 52-year-old female presents to an outpatient women's health clinic reporting irregular menses, hot flashes, mood swings, and disrupted sleep consistent with menopausal transition. The clinician orders a saliva hormone panel to assess levels of estradiol, progesterone, testosterone, and cortisol to aid symptom correlation and guide non-pharmacologic or hormonal management options. The patient is provided with a saliva collection kit and instructions for home collection of multiple timed samples (morning and evening) to capture diurnal variation. The specimen is returned to the clinic or mailed to a commercial reference laboratory; the laboratory processes the sample and reports quantitative hormone concentrations. Results are reviewed during a follow-up visit or via secure patient portal; documented interpretation links the hormone values to the patient’s menopausal symptoms and any proposed treatment plan. Typical site of service is an outpatient clinic or physician office; collection may occur at home with clinic oversight.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician interpretation/reporting portion if laboratory or separate entity performed analysis. |
59 |