LCD Reference Article Response To Comments Article

Response to Comments: Treatment of Males with Low Testosterone

A55053

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Article ID
A55053
Original ICD-9 Article ID
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Article Title
Response to Comments: Treatment of Males with Low Testosterone
Article Type
Response to Comments
Original Effective Date
07/12/2016
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The number of comments were few, partly because several clinical societies were given early drafts of this policy and the policy was adopted to include their suggestions.

Response To Comments

Number Comment Response
1 Commenter felt that morning levels of testosterone was not needed for older men, but guidelines from the societies recommend morning levels and suggested that doses of exogenous testosterone can affect fertility, and Medicare may cover younger men with various types of disabilities. The policy recommends bioavailable or free testosterone as types of tests to obtain. Many times there is more variability in the lab results than in the time of testing. Lower limits of testosterone are also not well standardized.
2 Commenter requested that baseline PSA (and subsequent levels after testosterone supplementation) be drawn before and after hormone therapy There is some controversy in the use of PSA as a screening test for prostate cancer, and there is disagreement in the literature as to the effect of exogenous testosterone on some prostate cancers. Noridian included the recommendation.
3 Commenter wanted Noridian to add words “replacement therapy” in the description of the policy. Noridian added the words "replacement therapy" to the description of the policy.
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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
Related Local Coverage Documents
LCDs
L36538 - Treatment of Males with Low Testosterone
Related National Coverage Documents
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Updated On Effective Dates Status
05/12/2016 07/12/2016 - N/A Currently in Effect You are here

Keywords

  • Treatment
  • Males
  • Low Testosterone
  • 11980
  • 96372
  • J1071
  • J3121
  • J3145
  • J3490