Blue Shield: Covered Diagnosis For Vitamin D Testing

Thursday, October 24, 2019

Covered Diagnosis For Vitamin D Testing

Bone diseases prior to specific treatment where correcting vitamin D deficiency is appropriate. Normal levels of Vitamin D range from 20 50 ngdl.

Codes For Laboratory Testing For And Diagnosis Of Micronutrient Deficiency Download Table

This document does not address testing for vitamin D.

Covered diagnosis for vitamin d testing. However standard blood tests may not include screening for vitamin D. Once a beneficiary has been shown to be vitamin D deficient further testing may be medically necessary only to ensure adequate replacement has been accomplished. Breast and colon cancer.

Vitamin D testing is a non-invasive blood test which can aid in the identification and clinical management of individuals at-risk for vitamin D deficiency. If the Vitamin D level is between 20 and 50 ngdl and the patient is clinically stable repeat testing is considered NOT MEDICALLY NECESSARY. Once a patient has been shown to be vitamin D deficient further testing may be considered MEDICALLY NECESSARY to ensure adequate replacement has been accomplished.

Vitamin D testing may be considered medically necessary and therefore covered only in patients with clinical diagnoses of one or more underlying diseases or conditions specifically associated with vitamin D deficiency or decreased bone density. In fact testing isnt helpful for most since experts have yet to agree on what low vitamin D. This LCD identifies the indications and limitations of Medicare coverage.

Medicare Limited Coverage Tests Covered Diagnosis Codes Source. This test is appropriate for assessment of Vitamin D deficiency. 25 hydroxy includes fractions if performed.

If level 60 ngdl are noted a subsequent levels may be reimbursed until the level is within the normal range. Want to know whether or not you are vitamin D deficient. For patients who exhibit symptoms of vitamin D deficiency and for those whose physicians deem a screening medically necessary Tricare.

Vitamin D deficiency has been linked to maladies such as. Testing for Vitamin D Deficiency. These tests may be covered by Medicare Part B as long as you doctor orders the tests and deems them medically necessary.

Claims for vitamin D tests are reviewed after submission based on the diagnosis listed. Its not reasonable and necessary to perform more than three tests per year. Fortunately there are tests available.

25 hydroxy and Vitamin D. Vitamin D tests that do not include a diagnosis from the Vitamin D Testing diagnosis. When is 25-hydroxyvitamin D blood testing covered.

Vitamin D testing is considered medically necessary in a non-pregnant individual age 18 64 years for any of the following. If repeat testing is performed documentation. Clinical disorders related to vitamin D may arise because of altered availability of the parent vitamin D altered conversion of vitamin D to its predominant metabolites altered organ responsiveness to dihydroxylated metabolites and disturbances in the interactions of the vitamin D metabolites with PTH and calcitonin.

Condition or medical diagnosis associated with Vitamin D deficiency See Appendix A previously documented Vitamin D deficiency. If Vitamin D level is between 20 and 50 ngdl and patient is. On average a vitamin D deficiency test can cost 50 typically covered by health insurance.

Medicare Coverage for Vitamin D Testing. If Vitamin D level is between 20 and 50 ngdl and patient is clinically stable repeat testing is often unnecessary. However they arent for everyone.

If you have Original Medicare you will usually pay 20 of the cost of your services and the Part B deductible will apply. Testing for vitamin D levels is covered when a person has signs or symptoms of vitamin D deficiency or risk factors for vitamin D deficiency. Component sources of 25-OH vitamin D such as stored D or diet-derived D should not be billed separately.

In 2014 in upstate New York an estimated 33 million was spent on vitamin D testing according to an Excellus BCBS infographic Vitamin D Tests. Vitamin D Assay Testing Local Coverage Determination. It should not be ordered in addition to Vitamin D.

This document addresses routine testing of serum vitamin D levels in adults and children in the absence of clinical signs and symptoms of vitamin D deficiency or intoxication or conditions for which vitamin D supplementation may be recommended. Musculoskeletal symptoms that could be attributed to vitamin D deficiency NOS states that although the symptoms of vitamin D deficiency are vague and it can be difficult to ascertain whether a low serum 25 OHD level is causal or a surrogate marker for example of poor nutrition or a lack of outdoor activity it is reasonable to test people suspected of having symptoms. Patients with Vitamin D deficiency that have been supplemented to normal levels are limited to one test per year.

Generally blood tests and screenings are performed as an outpatient procedure at your physicians office or in a laboratory facility. This LCD outlines the indications for Vitamin D 25-hydroxy. Vitamin D 125-dihydroxy is primarily indicated during patient evaluations for hypercalcemia and renal failure.

It recommends the measurement of serum 25 OH vitamin D 25OHD to estimate vitamin D status in the following clinical scenarios. Musculoskeletal symptoms that could be attributed to vitamin D deficiency. If performed documentation must clearly indicate the necessity of the test.

Code Description 82306 Vitamin D. Noridian Solutions LLC Vitamin D Assay Testing effective January 21 2019 Effective January 21 2019 Medicare Limited Coverage Tests. Bone diseases that may be improved with vitamin D treatment.

This Coverage Policy addresses serum Vitamin D testing. The guideline also states that routine vitamin D testing is unnecessary where vitamin D. When is 25-hydroxyvitamin D blood testing not covered.

0038U- Vitamin D 25 hydroxy D2 and D3 by LC-MSMS serum microsample quantitative UnitedHealthcare Community Plan will allow four Vitamin D tests per year when submitted with an appropriate ICD-10 diagnosis code plus the codes UnitedHealthcare has added to that list in any position. 1 25 dihydroxy laboratory testing is not covered for BlueCHiP for Medicare and not medically necessary for Commercial Products for all other indications including routine or other screening as the evidence is insufficient to determine the effects of the technology on health outcomes. Based on age 600 IU per day for ages 1 to 70 years of age.

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