News for Physicians

Medicare places restrictions on Vitamin D testing

Medicare has recently modified its reimbursement policy for Vitamin D testing. Reimbursement for laboratory testing for patients with Medicare Part A insurance will now require a medically necessary ICD-9 diagnosis code. If a valid diagnosis code is not provided, your office will be called to provide a valid diagnosis code.

ICD-9 Codes that support Medical Necessity

ICD-9 Codes that will be rejected

252.00 Hyperparathyroidism, Unspecified V70.0 Office Visit (Preventative Health Care)
252.01 Primary Hyperparathyroidism 401.1 Hypertension Benign
252.02 Secondary Hyperparathyroidism, Non-Renal 780.79 Fatigue and malaise
252.08 Other Hyperparathyroidism 714.0 Rheumatoid Arthritis
252.1 Hypoparathyroidism  
268.0 Rickets Active  
268.2 Osteomalacia Unspecified  
268.9 Unspecified Vitamin D Deficiency  
275.3 Disorders of Phosphorus Metabolism  
275.41 Hypocalcemia  
275.42 Hypercalcemia  
585.3 Chronic Kidney Disease, Stage III (Moderate)  
585.4 Chronic Kidney Disease, Stage IV (Severe)  
585.5 Chronic Kidney Disease, Stage V  
585.6 End Stage Renal Disease  
588.81 Secondary Hyperparathyroidism (of renal origin)  
733.00 Osteoporosis Unspecified  
733.01 Senile Osteoporosis  
733.02 Idiopathic Osteoporosis  
733.03 Disuse Osteoporosis  
733.09 Other Osteoporosis  
733.90 Disorder of Bone and Cartilage Unspecified  

View the CMS policy by clicking here.

Please contact our Laboratory Client Services Department at (781) 979-3151 if you have any questions.

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