CMS Measurement of Salivary Hormones Form

Summary Of Evidence

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Analysis of Evidence

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Hormones, both endocrine and exocrine, are secreted into various bodily fluids and their measurement can often diagnose diseases or be used to follow the course of a disease. Traditionally endocrine hormones are measured in serum, plasma, or urine. Measurements of hormones at certain times of the day, or after various attempts at suppression or stimulation can be used for diagnoses of endocrine diseases. Recently some labs have attempted to develop measurement of hormones in salivary secretions. Material is collected from saliva and sent to a lab for measurement. The convenience of collection without need of arterial or venipuncture simplifies collection, but the accuracy of measurement and lack of standardization makes the values determined still investigational. Noridian Healthcare Solutions currently considers salivary cortisol collected in the evening for diagnosis of Cushing’s syndrome as the only medically necessary and reasonable hormone measurement from salivary fluid. All other determinations of salivary hormones (e.g., thyroid, testosterone, estrogen, parathyroid, growth hormone, etc.) are considered investigational.