Good to know. I haven’t looked up all the codes on the form they gave me to see what they filed it under to be honest. I certainly hope they aren’t doing anything they shouldn’t.
Is there no possible way in the eyes of insurance to diagnose based on symptoms as well? I read something saying that was an option as well, though it was seldom utilized. Obviously, what I read could be wrong.
Oh, I completely get it. I don’t blame the providers at all. If I ran a TRT clinic, I would not accept insurance. The system isn’t set up for it at all.
The issue we all have, I think, is this…
…our issue is with the insurance establishment. For some reason they go off of Total T, which is obviously such a bad indicator of whether you need TRT. It’s all antiquated and ignorant.
We need an insurance provider that actually understands the sum of the literature for good doctors who know what they’re doing to be able to go through insurance and build up their practices as they deserve. I’d love to see the best TRT doctors get stupidly wealthy.
No. You have to meet criteria for the diagnosis code. Some clinics think they can get around it by giving codes for symptoms like fatigue for instance. Those clinics are getting shut down. For their own protection the providers should always dictate they are treating symptoms with testosterone off label. Please understand. To traditional medicine and insurance companies it is not okay to treat a person with normal levels. It is as simple as that
This is very interesting, thanks for posting to clear this up @yeti308.
I had some strange bump for the second test, but these are my 3, AM fasted testosterone readings when I first started investigating my issues…and I do have a Hypogonadism diagnosis. So with these and a diagnosis code, I could go practically anywhere and insurance would cover it?
11/06/2017: Testosterone: 251
08/17/2017: Testosterone: 280
08/03/2017: Testosterone: 244
Edit - I was 41 when these were taken
I’m so fed up with traditional medicine and insurance companies. It really is a system of sick care and is reflective of society’s demonization of all things male while feminine energy is hailed as what we should all be aspiring to.
Man, it’s so crazy how we ended up in practically the same place – though obviously my dosage is higher – when my initial T readings were 1,000 above this. Same solution!
Did you happen to see the article I linked in another thread that talked about the American physological society and what they said about traditional masculinity? That right there will piss you off.
Ha, I didn’t see you post it but I did actually read that article when it came out. Unbelievable!
Laura Ingraham: “Traditional masculinity seems to be, in this report at least, conflated with being a pig, or a creep, or a Harvey Weinstein kind of person.”
Great for you. I do not get to frequent forums often due to work and research. I will randomly do it to see what is being propagated on the forums as far as it being non evidence based. Everyone should know what their patients are potentially reading.
Also, I left the Lifting dermatologist Fb page and YouTube channel purely because they were moving in a different direction. It’s okay to talk about anabolic steroids and associated topics but we need to keep a safe distance from that. We are trying to do research to show why men with normal levels can be symptomatic (type 3 hypogonadism secondary to EDCs).
Now to clarify the whole Bossa thing. He was just upset we left the group but he talked to me (in a text) in a very derogatory and disrespectful way. I Responded with the exact statement that if you ever talk to me that way again I will beat the living shit out of you. So I wish them the best with what they do but I have a different mission ahead of me. We are doing what you desperately want someone to do and that is to provide evidence that men with normal levels need help and that it is appropriate. We need to totally change how we define normal
I meet the criteria @bkb333…my LH and FSH were well within range, my nuts aren’t working
Those are codes for hypogonadism. So if you met criteria then it is appropriate to submit. If you didn’t they are committing fraud. It doesn’t matter to the insurance companies whether it comes out of ignorance or greed. It’s all the same to them. Whatever provider it is he or she is just asking for trouble
Yes you did. It is appropriate to give you the code and bill insurance
Thank you @yeti308.
These are from my urologist. I had all the symptoms, my LH and FSH were fine and my fasted AM levels were low:
11/06/2017: Testosterone: 251
08/17/2017: Testosterone: 280
08/03/2017: Testosterone: 244
Thanks again, I appreciate the chat.
I’m really glad you do this and wish more doctors did – it’s a testament to your dedication, as I know you have many responsibilities. I think it’s important to know what’s being put out there because these forums have a huge influence on all of us who read them. We’re all learning together and need expert voices who really know what they’re talking about…unfortunately, there aren’t that many of them out there.
I just discovered them and didn’t realize they were pro-anabolics – seemed to be mainly a TRT type focus to me. But like I said, I’m new. A genuine shame that he spoke to you that way.
Thank God. That’s what we need!
Hypothetically speaking - with my diagnosed hypogonadism, my age (over 40) and my diagnosis codes - could I become a client of yours @yeti308 and have my treatment covered by insurance?
Since the vast majority of who we see are “within normal range” we are not even set up for insurance (it would require additional staff just for the additional paperwork) but with men like you I gladly advise and will even advise and direct their physician (if they are open to it) at no charge. I’m glad when someone is able to use insurance and use their physician. So if your physician is open to it I will happily make recommendations and talk with him directly
Just so I am very clear. When I see a man in consultation that meets all the criteria for hypogonadism I encourage him to go through his physician and use insurance.
But look, it’s even more complicated than you can really write on a forum. We are a preventative medicine program. Testosterone is just one of the hormones. The other major hormone to optimize is thyroid. Now the rules are the same for thyroid but it is even more restrictive and nothing angers the family physician more than someone treating thyroid when the patient has normal levels. More physicians are reported to their boards by other physicians and pharmacists for using thyroid than testosterone. So if I took insurance for testosterone but then also needed to optimize his thyroid which I do in most men I couldn’t because hardly anyone meets criteria for hypothyroidism. So to summarize basically nobody has both hypogonadism and hypothyroidism using the guidelines. So I want to treat both and not just one. I hope this makes sense to everyone.
I might be a unicorn? At the moment, I’m taking 2.5 grains of Armour Thyroid for hypothyroidism. I think I was technically “sub-clinical” hypothyroid though, so not that special I guess.
My thyroid numbers before starting Armour Thyroid -
TSH - 3.53 uIU/ML (0.400 - 4.100)
T3 Total - 0.91 ng/ml (0.80 - 2.00)
T4 Total - 5.3 MCG/DL (4.5 - 11.7)
TRIIODOTHYRONINE, REVERSE - 14.3 ng/dl (9.0 - 27.0)
At the moment, we’re working on both.
I very much appreciate your response and idea @yeti308. So far, my doc has been pretty good with helping me, I just wonder if he’d be willing to let me work my levels higher for full symptom relief… And if he isn’t, I would love to be able to use you as a consult reference if that would be acceptable?
Appreciate the responses and time, thank you!
How do you know when to treat thyroid? Here’s my labs for example. I’ve heard 8 different things from 8 different people on if there’s a problem and what to do about it. It’s overwhelming. I finally got TRT as good as I could have ever imagined and I’m scared to F with thyroid. My issues aren’t TRT related as they feel like a completely different thing. Does anything pop out at you? My father has hashimotos and my mom has hypothyroidism but doesn’t treat it.
TSH - 1.610 (.450 - 4.50)
FT4 - 1.21 (0.82 - 1.77)
FT3 - 3.5 (2.0 - 4.4)
RT3 - 21.1 (9.2 - 24.1)
TPO ab - 19 (0 - 34)
TG ab - <1 (0 - 0.9)
So I guess that by this logic, insulin would be considered an “addictive” drug as well?
They are defining addictive as “you can feel it leaving your body, leaving the individual wanting more”.
Well NO SHIT! If you are hypogonadism, then your body isn’t replacing testosterone the way it should be.
It’s not called addiction, it’s called dependency, and as negative as that term sounds…(it’s a mind fuck to me that this would even have to be debated in 2019)… diabetics are dependent upon insulin. People with asthma are dependent upon an inhaler. Hell, EVERYONE is dependent upon OXYGEN!! I guess I’m addicted to breathing too!! Lmao
Okay rant over.
I have never personally seen the FB group that you were part of (or even joined FB in the first place lol), but I have had interactions with Danny on this forum several times. I applaud you for standing on what you believe and not allowing the “tides” of a growing movement sweep you off course of what you are trying to accomplish. Very glad to hear that and, not that this means anything to you or anyone else, you have my respect.