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The Marshall Protocol Study Site > MEMBER DISCUSSION > Public Questions and Discussion > codes to use to get insurance coverage for Vit. D test


codes to use to get insurance coverage for Vit. D test
 Moderated by: Dr Trevor Marshall  

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jcwat101
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Joined: Tue Jul 20th, 2004
Location: Pasadena, USA
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 Posted: Tue Jul 20th, 2004 23:50

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I am new and inquiring for my 81 year old mother who has a lot of arthritis and low back pain, fibromyalgia and fatigue and high CRP, high BP, CAD calcifications and high triglycerides.

I am wondering what diagnosis or CPT code she might use to get her Vit. D tests covered by Medicare? She had her back scanned for osteoporosis and it was in the normal range, though they told her she had a lot of calcifications so it was not that accurate. For instance, L5 registered as very high bone density, but probably due to calcifications.

Joyce



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 Posted: Wed Jul 21st, 2004 09:33

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Joyce,

I do not have personal experience billing Medicare for serum D-metabolite testing, but patients have reported that Medicare has covered these tests. Possibly the criteria for coverage would be similar to medically necessary ionized calcium testing with Medicare.

Some diagnosis codes supporting medical necessity for calcium testing under Medicare are:
275.40 Unspecified disorders of calcium metabolism
275.42 Hypercalcemia
278.4 Hypervitaminosis D
733.00 Osteoporosis, unspecified

Medicare requirements for covering testing for ionized calcium can be found at this URL: http://www.empiremedicare.com/NJBULL/njb2001-5/ion.htm

The doctor's office will be familiar with documentation in the medical file that will support medical necessity, but you might want to review the list at the URL above to see if any terms are related to your mother's case, so you can it discuss with the doctor.

Belinda

paulalbert
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Joined: Fri Jul 16th, 2004
Location: New York USA
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 Posted: Fri Jan 21st, 2005 18:08

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I've been having trouble finding the correct CPT codes myself for the serum D metabolites test. This is not the diagnosis code, mind you, but the procedure code itself.

According to McClendon Clinical Laboratories in North Carolina, the two CPT codes are as follows:

--Vitamin D (1,25): 82652

--Vitamin D (25OH): 82306

I haven't seen these anywhere up on the MP message board....

Paul



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