Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Sex Hormone-Binding Globulin (SHBG) is a protein synthesized by the liver that binds tightly to the sex hormones testosterone, dihydrotestosterone (DHT), and estradiol, transporting them in an inactive form throughout the bloodstream. In men, approximately 45–65% of circulating testosterone is bound to SHBG, while most of the remaining testosterone is loosely bound to albumin, and only about 2–3% circulates as free testosterone. Since albumin-bound testosterone is also bioavailable, both free and albumin-bound fractions represent the portion of testosterone readily available to tissues. In women, a higher proportion of testosterone (66–78%) is bound to SHBG compared to men. Because SHBG has a higher affinity for testosterone and DHT than for estradiol, alterations in SHBG concentration can significantly influence the levels of bioavailable androgens and estrogens, contributing to clinical manifestations such as androgen excess when SHBG is low.
Measuring total testosterone provides a general assessment of androgen status but does not differentiate between bound and unbound fractions. When SHBG levels are abnormal, total testosterone alone may not accurately reflect the biologically available hormone. Therefore, SHBG testing is often performed alongside total testosterone in cases where clinical symptoms of androgen deficiency or excess do not align with total testosterone results. SHBG levels can be influenced by several physiological and pathological factors, including sex, age, obesity, thyroid dysfunction, and liver disease. Interpreting SHBG in conjunction with total testosterone provides a more accurate evaluation of hormonal balance and tissue availability.
Reference:
Rosner W, Hryb DJ, Khan MS, Nakhla AM, Romas NA. Sex hormone-binding globulin: anatomy and physiology of a new regulatory system. J Steroid Biochem Mol Biol. 1991;40(4-6):813-820. doi:10.1016/0960-0760(91)90282-3
Statement on Medical Necessity
All ordered tests should be medically necessary for the diagnosis or detection of disease, illness, impairment, symptom, syndrome, or disorder and the results should be used in the medical management and treatment decisions for the patient. Solaris requires ICD-10 codes with each order for lab testing and both the tests ordered and the diagnosis should be documented in the provider’s medical record for the patient. The United States Department of Health and Human Services, Office of Inspector General, takes the position that a provider who orders medically unnecessary tests may be subject to civil penalties.
Panels and Profiles
Solaris offers Providers the convenience of ordering test combinations in a group at times with the flexibility to choose appropriate test(s) for individual patients. Providers should only order those tests that he or she believes are medically necessary for each patient, and a lesser inclusive profile or individual tests should be ordered if not all tests in the test combination/profile are medically necessary. All tests offered in a test combination/profile may be ordered separately as individual tests. Solaris encourages clients to contact their Solaris representative if the testing configurations shown do not meet individual needs for any reason, or if some other combination of procedures is needed.
CPT Codes
CPT Codes listed are in accordance with Current Procedural Terminology, a publication of the American Medical Association. CPT codes are the responsibility of the billing party and are listed here for informational purposes. Correct coding may vary from one carrier to another. Solaris may bill specific carriers using codes other than what is shown.
For questions or inquiries related to testing please reach out to
customerservice@solarisdx.com or contact us by phone at (844) 550-0308.
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