Vitamin D Testing

What ICD-9 code/s would you use when ordering a vitamin d test on a patient that presents for a signs of vitamin d deficiency?

re: Vitamin D Testing

Code the "signs".

re: Vitamin D Testing

Depends on the health plan. Medicare does not cover a Screening Vitamin D. Some commercial plans will cover screening Vitamin D with a V70.0

The LCD for the CMS carrier, Noridian are:

http://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=31371&ContrId=83&ver=5&ContrVer=1&CoverageSelection=Local&ArticleType=All&PolicyType=Final&s=Minnesota&CptHcpcsCode=82306&lcd_id=12728&lcd_version=55&basket=lcd%253A12728%253A55%253AUrinalysis+Policy%253AFI%253ANoridian+Administrative+Services%257C%257C+LLC+%252800320%2529%253A&bc=gAAAABAAAAAAAA%3d%3d&

ICD-9 Codes that Support Medical Necessity

The following ICD-9 CM codes support the medical necessity of CPT® code 82306
252.00 HYPERPARATHYROIDISM, UNSPECIFIED
252.01 PRIMARY HYPERPARATHYROIDISM
252.02 SECONDARY HYPERPARATHYROIDISM, NON-RENAL
252.08 OTHER HYPERPARATHYROIDISM
252.1 HYPOPARATHYROIDISM
261 NUTRITIONAL MARASMUS
262 OTHER SEVERE PROTEIN-CALORIE MALNUTRITION
268.0 RICKETS ACTIVE
268.2 OSTEOMALACIA UNSPECIFIED
268.9* UNSPECIFIED VITAMIN D DEFICIENCY
275.3 DISORDERS OF PHOSPHORUS METABOLISM
275.40* UNSPECIFIED DISORDER OF CALCIUM METABOLISM
275.41 HYPOCALCEMIA
275.42 HYPERCALCEMIA
278.4 HYPERVITAMINOSIS D
571.9 UNSPECIFIED CHRONIC LIVER DISEASE WITHOUT ALCOHOL
579.0 CELIAC DISEASE
579.1 TROPICAL SPRUE
579.2 BLIND LOOP SYNDROME
579.3 OTHER AND UNSPECIFIED POSTSURGICAL NONABSORPTION
579.4 PANCREATIC STEATORRHEA
579.8 OTHER SPECIFIED INTESTINAL MALABSORPTION
579.9 UNSPECIFIED INTESTINAL MALABSORPTION
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
733.09 OTHER OSTEOPOROSIS
733.90 DISORDER OF BONE AND CARTILAGE UNSPECIFIED
756.52 OSTEOPETROSIS
268.9* If more than one LCD-listed condition contributes to Vit. D deficiency in a given patient and/or is improved by Vit. D administration, coders should use: ICD-9-CM 268.9 UNSPECIFIED VITAMIN D DEFICIENCY. This code should not be used for any other indication.

275.40* Use only for HYPERCALCIURIA

The following ICD-9-CM codes support the medical necessity of CPT® code 82652
268.0 RICKETS ACTIVE
268.2* OSTEOMALACIA UNSPECIFIED
275.40* UNSPECIFIED DISORDER OF CALCIUM METABOLISM
275.42* HYPERCALCEMIA
592.0 CALCULUS OF KIDNEY
592.1 CALCULUS OF URETER
592.9 URINARY CALCULUS UNSPECIFIED
268.2* Use only for tumor-induced osteomalacia
275.40* Use only for unexplained hypercalciuria
275.42* Use only for unexplained hypocalcemia

Charlene Endre-Burgett, MS, CMA (AAMA), CPC, CMSCS
Administrator, North Scottsdale Family Medicine
Blog: www.charleneburgett.wordpress.com
LinkedIn: www.linkedin.com/in/charleneburgett