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Coverage criteria policies

Bio-identical hormone replacement and saliva hormone testing for treatment of menopause

These services may or may not be covered by your HealthPartners plans. Please see your plan documents for your specific coverage information. If there is a difference between this general information and your plan documents, your plan will be used to determine your coverage.

Administrative Process

These procedures are not covered and do not require prior authorization. Please see the related content at the right for link to investigational services – list of noncovered services policy for additional payment liability information.

Coverage

Bio-identical hormone replacement and saliva hormone testing are not covered because they are considered experimental / investigational.

Definitions

Salivary hormone testing may be ordered by practitioners as a guide to bio-identical hormone in the treatment of menopause. Additionally, these tests are being offered over the Internet for home testing. Saliva is collected by the individual at home. The sample is then sent to a laboratory for evaluation. Results of the test may then be used to determine the need for prescriptions for products such as vitamins, herbs, and phytoestrogens.

Bio-identical hormone replacement therapy (BHRT), also known as bio-identical hormone therapy or natural hormone therapy is a generally ill-defined term that frequently refers to the use of hormones that are supposedly identical to a patient’s needs for replacement hormones. It is also strongly associated with pharmacy compounding, blood or saliva testing, and attempts to reach a targeted level of hormones in the body (as established through blood or saliva testing).

If available, codes are listed below for informational purposes only, and do not guarantee member coverage or provider reimbursement. The list may not be all-inclusive.

Codes

Description

S3650

Saliva test, hormone level; during menopause

No codes available for bio-identical hormone treatment.

CPT Copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Products

This information is for most, but not all, HealthPartners plans. Please read your plan documents to see if your plan has limits or will not cover some items. If there is a difference between this general information and your plan documents, your plan documents will be used to determine your coverage. These coverage criteria may not apply to Medicare Products if Medicare requires different coverage. For more information regarding Medicare coverage criteria or for a copy of a Medicare coverage policy, contact Member Services at 952-883-7979 or 1-800-233-9645.

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Policy activity

  • 08/11/2010 - Date of origin
  • 11/01/2010 - Effective date
Review date
  • 09/2015

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