All PlansCoverageMedium impact
Estrogen Hormone Testing: Estradiol and Estrone
Blue Cross & Blue Shield of Mississippi·MS · Endocrinology, OB-GYN, Oncology +2 more·Medical Policy
We identified it
Jun 20, 2026
Summary
This is a comprehensive policy establishing coverage criteria for estrogen hormone testing (estradiol and estrone). The policy defines when these tests are considered medically necessary versus not covered, with specific exclusions for infertility and sex transformation treatments.
Action Required
Billing team should review current estrogen hormone test claims to ensure they meet medical necessity criteria. Verify that claims for CPT codes 82670, 82671, 82672, 82679, and 82681 have appropriate documentation showing symptoms of hypoestrogenism/hyperestrogenism, hormone replacement therapy monitoring, or antiestrogen therapy monitoring. Do not bill these tests for screening in asymptomatic patients as they will be denied.