About Laboratory Tests
Q: Are laboratory tests required?
A: Yes. Hormone support and replacement is based on a deficiency in your body. Baseline testing can usually be done by simple blood work and is usually covered by your insurance. Occasionally saliva or urine testing is needed depending on your clinical situation. After starting on hormone therapy, your response is usually measured by salivary testing as this is the most accurate method and most convenient for the patient, particularly if tests are required at different times of the day.
Q: Do I need my lab tests before my initial appointment?
A: Having your baseline lab tests before your initial consultation is convenient, but not necessary. Dr. Norton cannot order any tests prior to your initial visit because a doctor-patient relationship does not yet exist. However, a patient can schedule an initial consultation and then the necessary testing will be ordered specifically for you.
If your usual doctor is willing to order a baseline hormone profile, please tell your doctor the blood tests that should be included are as follows:
Women:
Estradiol 82670
Progesterone 84114
DHEA-S 82627
Total Testosterone 84403
Free Testosterone 84402
TSH 84443
Free T3 84481
Free T4 84439
Reverse T3 84482
Ferritin 82728
Vitamin D, 25-hydroxy 82306
CMP 80053
Lipid Profile 80061
IGF-1 84305
CBC automated 85025
Men:
Total Testosterone 84403
Free Testosterone 894402
DHEA-S 82627
TSH 84443
Free T3 84481
Free T4 84439
Reverse T3 84482
CBC automated 85025
PSA 84153 (if not recent)
Vitamin D, 25-hydroxy 82306
CMP 80053
Lipid Profile 80061
IGF-1 84305
In New York, it is possible to purchase blood testing panels yourself (without a doctor’s order), and have your bloods drawn at a laboratory for a nominal fee. This option is a bit expensive and may not be covered by your insurance.
Q: Are laboratory tests covered by my insurance?
A: Yes, for most blood work and most insurance carriers. After starting on hormone replacement, the most accurate method to evalute your hormone levels is salivary testing. Because this is a new and highly sophisticated technology, these salivary tests are sent to a specialty laboratory and must be pre-paid. All necessary forms are provided so you may forward your expenses to your insurance company for reimbursement.
Some insurances limit their customers to particular laboratories with which the insurance company has a contract, and will only pay for the tests these laboratories offer. Because salivary testing for hormone levels is state of the art and requires highly sophisticated testing methods, some of these laboratories are not equipped to process these tests. Payment is then a matter of your contract with your insurance company. If your contract allows for evaluation by any laboratory, the forms for submission to your insurance carrier will be given to you to submit for payment.
