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what medical diagnosis medicare code covers a vitamin d blood test

by Fabiola Kshlerin MD Published 3 years ago Updated 2 years ago

2. For 82306: If more than one LCD-listed condition contributes to Vitamin D deficiency
Vitamin D deficiency
Vitamin D deficiency or hypovitaminosis D is defined as a vitamin D level that is below normal. It most commonly occurs in people when they have inadequate sunlight exposure (in particular sunlight with adequate ultraviolet B rays (UVB)).
https://en.wikipedia.org › wiki › Vitamin_D_deficiency
in a given patient and/or is improved by Vitamin D administration, coders should use: ICD-10 E55. 9 UNSPECIFIED VITAMIN D DEFICIENCY. This code should not be used for any other indication.

Full Answer

What is the diagnosis code for vitamin D screening?

Vitamin D Assay Testing Local Coverage Determination. CPT Codes: Code Description 82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 82652 Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed . The following ICD-10-CM codes support the medical necessity of CPT code 82306: Code Description A15.0 Tuberculosis of lung

Is vitamin D testing covered by Medicare?

Medicare Coverage for Vitamin D Testing Generally, blood tests and screenings are performed as an outpatient procedure at your physician’s office or in a laboratory facility. These tests may be covered by Medicare Part B as long as you doctor orders the tests and deems them medically necessary.

What is the CPT code for vitamin D screening?

  • Chronic kidney disease stage III or greater
  • Osteoporosis
  • Osteomalacia
  • Osteopenia
  • Hypocalcemia
  • Hypercalcemia
  • Hypercalciura
  • Hypoparathyroidism
  • Hyperparathyroidism
  • Malabsorption states

More items...

What diagnosis covers vitamin D?

  • osteosclerosis/petrosis
  • rickets
  • vitamin D deficiency on replacement therapy related to a condition listed above; to monitor the efficacy of treatment.

What ICD-10 codes cover vitamin D level?

4. Assays of the appropriate vitamin D levels for ICD-10 codes E55. 0, E55.

What diagnosis code can be used for vitamin D?

E55. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

What diagnosis will cover vitamin D level?

The measurement of 25(OH) Vitamin D levels will be considered medically reasonable and necessary for patients with any of the following conditions: Chronic kidney disease stage III or greater. Hypercalcemia. Hypocalcemia.

Is Vit D test covered by Medicare?

For Medicare beneficiaries, screening tests are governed by statute. Vitamin D testing may not be used for routine screening. Once a beneficiary has been shown to be vitamin D deficient, further testing is medically necessary only to ensure adequate replacement has been accomplished.

Does Medicare pay for vitamin D levels?

Do Medicare prescription drug plans cover vitamin D3? No. In general, Medicare prescription drug plans (Part D) do not cover this drug.

Is vitamin D blood test covered by insurance?

On average, a vitamin D deficiency test can cost $50, typically covered by health insurance.

What is the ICD-10 code for vitamin d3?

ICD-10 | Vitamin D deficiency, unspecified (E55. 9)

Why is vitamin D testing not covered?

Vitamin D testing is unproven and not medically necessary for routine preventive screening due to insufficient evidence of efficacy. Vitamin D testing is proven and medically necessary for conditions or medical diagnoses associated with Vitamin D deficiency or risk of hypercalcemia.

What is ICD-10 code for vitamin deficiency?

ICD-10 code E56. 9 for Vitamin deficiency, unspecified is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases .

What diagnosis codes cover 82306?

Group 1CodeDescription82306VITAMIN D; 25 HYDROXY, INCLUDES FRACTION(S), IF PERFORMED82652VITAMIN D; 1, 25 DIHYDROXY, INCLUDES FRACTION(S), IF PERFORMED

Document Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

This LCD supplements but does not replace, modify or supersede existing Medicare applicable National Coverage Determinations (NCDs) or payment policy rules and regulations for Vitamin D; 25 hydroxy, includes fraction (s), if performed.

Coverage Guidance

History/Background and/or General Information Vitamin D, a group of fat-soluble prohormones, is an essential Vitamin. There are two major types of Vitamin D (Vitamin D2 and Vitamin D3) which are collectively known as calciferol.

General Information

CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Title XVIII of the Social Security Act, Section 1862 (a) (1) (A) states that no Medicare payment shall be made for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury. Title XVIII of the Social Security Act, Section 1862 (a) (7).

Article Guidance

The following coding and billing guidance is to be used with its associated Local coverage determination.

ICD-10-CM Codes that DO NOT Support Medical Necessity

All ICD-10-CM codes not listed in this policy under ICD-10-CM Codes that Support Medical Necessity above.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

Document Information

CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Title XVIII of Social Security Act, Section 1861 Act provides for payment of clinical laboratory services under Medicare Part B.

Coverage Guidance

Vitamin D is a hormone, synthesized by the skin, the liver, and then metabolized by the kidney to an active hormone, calcitriol. An excess of vitamin D may lead to hypercalcemia. Vitamin D deficiency may lead to a variety of disorders.

Document Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

Title XVIII of the Social Security Act, Section 1862 (a) (1) (A) states that no Medicare payment shall be made for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury. Title XVIII of the Social Security Act, Section 1862 (a) (7).

Coverage Guidance

Hypovitaminosis D may result from inadequate intake, insufficient sunlight, malabsorption, liver, kidney and genetic disease. It results in the inadequate mineralization of bone. The CDC reported approximately 300,000 hip fractures, 60,000 fall-related deaths and 33 billion dollars in health care expenditures in 2014.

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