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Laboratory Services

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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