Medical Policy Vitamin D Assay Testing
Medical Policy Vitamin D Assay Testing
Table of Contents
? Policy: Commercial
? Policy: Medicare
? Authorization Information
? Coding Information ? Description ? Policy History
? Information Pertaining to All Policies ? References ? Endnotes
Policy Number: 746
BCBSA Reference Number: 2.04.135 NCD/LCD: Local Coverage Determination (LCD): Vitamin D Assay Testing (L37535)
Related Policies
None
Policy1 Commercial Members: Managed Care (HMO and POS), PPO, and Indemnity Medicare HMO BlueSM and Medicare PPO BlueSM Members
Measurement of 25-OH Vitamin D (CPT 82306) level is considered MEDICALLY NECESSARY for patients with any of the following conditions:
? Chronic kidney disease stage III or greater ? Cirrhosis ? Hypocalcemia ? Hypercalcemia ? Hypercalciuria ? Hypervitaminosis D ? Parathyroid disorders ? Malabsorption states ? Obstructive jaundice ? Osteomalacia ? Osteoporosis if:
o T score on DEXA scan 3% 10-year probability of hip fracture or 20% 10-year probability of other major
osteoporotic fracture or o FRAX> 3% (any fracture) with T-score ................
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