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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