CurrentBlue Cross Blue Shield - New MexicoPolicy CPCPLAB034

Salivary Hormone Testing

This policy defines Blue Cross Blue Shield of New Mexico's reimbursement stance and code guidance for salivary hormone testing services for covered members and participating providers.

Policy Summary

PayerBlue Cross Blue Shield - New Mexico

PolicySalivary Hormone Testing

Policy CodePolicy CPCPLAB034

Change TypeAdded codeliterature reviewcode removals recorded

Effective DateAug 8, 2025

Next Review DateN/A

Key ActionSubmit accurate documentation and provide additional documentation upon request for claims subject to review.

SourceLink

POLICY UPDATE CHANGES

Document updated with literature review; reimbursement information unchanged.

Added code 0462U.

Removed multiple CPT/HCPCS codes including 82626, 82627, 82670, 82671, 82672, 82677, 82679, 82681, 84144, 84402, 84403, 84410.

1Supported indication (Cushing syndrome)

11Not reimbursable diagnoses listed

5Procedure codes listed

4History entries

Reimbursement Criteria

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Reimbursement criteria by indication

Reimbursement guidance for salivary hormone testing by indication:

ALL of the following

ALL of the following
- ALL of the following
  - ALL of the following
    Late‑night salivary cortisol testing may be reimbursable for diagnosis of Cushing syndrome.

ALL of the following

ANY of the following
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of menopause.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of infertility.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of endometriosis.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of PCOS.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of premenstrual syndrome.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of osteoporosis.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of sexual dysfunction.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of seasonal affective disorder.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of depression.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of multiple sclerosis.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of sleep disorders.
- ALL of the following
  - Salivary hormone testing is not reimbursable for screening, diagnosis, or monitoring of diseases related to aging.

Documentation and Claims

Documentation Required

Documentation and claim review — submit accurate documentation and provide additional information upon request

Providers must submit accurate documentation of services performed and code claims using valid HIPAA-approved code sets and industry-standard coding guidelines. Claims are subject to code edit protocols and may be reviewed against plan documents, provider contracts, medical policies, and coding software logic; upon request, providers must submit additional documentation.

Submit claims using valid code combinations from HIPAA-approved code sets (CPT, HCPCS, ICD-10-CM/PCS, NDC, DRG guidelines, etc.).
Code claims according to industry-standard guidelines (Uniform Billing Editor, AMA CPT Assistant, CMS NCCI policy manual and table edits).
Be prepared to provide additional documentation upon request for claim review.
Plan documents or provider contracts govern in case of conflict with this policy.

82530
82533
0462U
S3650
S3652

OpenPayer

Salivary Hormone Testing

Reimbursement Criteria

Procedure Codes and Coding Notes

Documentation and Claims

Definitions and Lab Management