CPT 82180 82306 82607: Assays Unveiling Vitamins and Metabolic Harmony
ICD CODE by Medicalbilling4u
Procedure Code 82306: Group 1 Codes
82306 VITAMIN D 25 HYDROXY - INCLUDES FRACTIONS IF PERFORMED
82652 VITAMIN D 1 25 DIHYDROXY - INCLUDES FRACTIONS IF PERFORMED
LCD Description:
Vitamin D is actually a hormone that is made by the skin and excreted by the kidney into the blood as the active form, calcitriol. Too much poses the risk for hypercalcemia, and deficiency can lead to a variety of diseases. This LCD details the extent of Medicare coverage and reimbursement of those services.
ICD10 DESCRIPTION:
- E55.9 Vitamin D deficiency unspecified
- E20.0 Idiopathic hypoparathyroidism
- E20.8 Other hypoparathyroidism, unspecified
- E20.9 E21.0 Primary hyperparathyroidism
- E21.1 E21.2 Other hyperparathyroidism, unspecified
- E21.3 Rickets active
- E55.0 Vitamin D deficiency unspecified
Since vitamin assay panels are classified by Medicare as screening tests, they are non-covered. Panels that test for multiple vitamins, minerals, antioxidants and metabolic functions are also unnecessary. Reimbursement depends on clinical need – illness diagnosis or treatment.
In contrast to generalised screening, diagnostic assessment should be more specific and target suspected deficiencies of one or more vitamins. The most common causes of deficiencies are of a nutritional nature, and supplementation could correct a variety of intracellular deficiencies. Vitamin tests should be clinical marker-driven; symptoms suggestive of a specific deficiency would lead to evidence-based testing to confirm a diagnosis.
Limitations For Medicare Beneficiaries:
Routine testing of vitamins and micronutrients is in violation of statutory criteria for screening tests Once vitamin deficiency has been confirmed, ongoing testing might be performed to monitor adequate replenishment, with further testing annually should indications and limiting factors exist.
And selenium (84255), functional intracellular analysis (84999), and total antioxidant function (84999), among other individualised and potentially unspecified assays do not meet these stipulations. Wide-open testing categories ‘non-specified’, and ‘unspecified’ code ‘see above’ — and blame the victim by not covering unspecified vitamin testing (84591) as they are already covering clinically specific assays for the pertinent vitamins.
Pertinent Laboratory Tests (excluding non-covered):
- 25-OH Vitamin D-3
- Carnitine
- Vitamin B-12
- Folic Acid
- Serum Homocystine
- Vitamin B-6, B-2, B-1
- Vitamin E
- Fibrinogen
- High-Sensitivity C-Reactive Protein
- Lipoprotein-associated phospholipase A2 (Lp-PLA2)
- Vitamin A, K
- Ascorbic acid
Additional Inclusion with Limited Coverage:
Vitamin D (not otherwise specified)
Notice:
This LCD outlines the reasons Medicare could deny the services automatically: if the services were not scribed as medically necessary based on Medicare’s indications, limitations, and general medical necessity edits.
Billing and Coding Guidelines:
- 12X Dangerous and illegal drugs Group health policy Medicare
- 13X Substances for narcotic treatment Group health policy Medical
- 14X Anti-convulsant drugs Group health policy Medicare
- 18X Vitamins Accident policy
- 1X1 Not required
- 1X2 Car accidents
- 1X3 Health issues
- 1X4 Dental issues
- 1X5 Terminal illness
- 1X6 Fire or explosion
- 1X7 Natural disasters
- 1X8 Surgical errors
- 1X9 Gunshot
- 21X Poisoning requirements Group health policy
- 111 Physio or rehab for cancer Medical
- 112 Psychiatric involuntary hold Group health policy
- 113 Angioplasty Medical
- 114 Chemotherapy Group health policy
- 115 Psychiatric in-patient treatment Group health policy
- 116 Radiology Medical
- 117 Major surgery Group health policy
- 118 Brain tumour
- 119 Private medical
- 120 Heart attack
- 121 Medication errors
- 122 Stroke
- 22X Social assistance Link to social worker Group health policy
- G1 Grief counselling & suicide methods Group health policy
- G2 Mental illness Group health policy
- G3 Assault Gender:
- G4 Rape
- 23X Aids requirements Group health policy Medical
- A1 Antiretroviral drugs Medical
- A2 Termination of aids funding due to negligence Medical
- A3 Prostatectomy Medical
- A4 Assisted reproductive technology Medical
- 83X Pandemic immunisation Group health policy
- 85X Infection control Medical
- 85X Quick immunisation Group health policy
Revenue Codes: 030X
CPT/HCPCS Codes:
- 82180: Assay of ascorbic acid
- 82306: Vitamin D 25-hydroxy (includes fractions if performed)
- 82379: Carnitine
- 82607: Cyanocobal amin (Vitamin B-12)
- 82652: Vitamin D 1,25-dihydroxy (includes fractions if performed)
- 82746: Folic Acid
- 83090: Homocysteine
- 83698: Assay lipoprotein pla2
- 84207: Pyridoxal phosphate (Vitamin B-6)
- 84252: Riboflavin (Vitamin B-2)
- 84425: Thiamin (Vitamin B-1)
- 84446: Tocopherol
- 84590: Assay of Vitamin A
- 84591: Assay of NOS vitamin
- 84597: Assay of Vitamin K
- 85385: Fibrinogen antigen
- 86141: C-reactive protein hs
- 86352: Cell function assay w/stim
- 86353: Lymphocyte transformation mitogen phytomitogen or antigen-induced blastogenesis
ALL codes require CL IA certification and QW Modifier.
Vitamin D Assays (CPT code 82306):
Vitamin D is an essential hormone synthesised by the skin and metabolised by the kidney into the active form of calcitriol. Excess Vitamin D can cause hypercalcemia. Its deficiency can be associated with various disorders. Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request.Paraphrase:LCD contains information about the specifics of Medicare's coverage and reimbursement for test assays such as Vitamin D.
ICD-10 Description for Vitamin D Assays (CPT 82306):
- M81.0: Age-Related Osteoporosis without Current Pathological Fracture
- E83.52: Hypercalcemia
- E83.51: Hypocalcemia
- M81.8: Other Osteoporosis without Current Pathological Fracture
- E55.9: Vitamin D Deficiency Unspecified
ICD-10 Description for Assay of Ascorbic Acid (CPT 82180):
- V12.1: Personal history of nutrition deficiency
- V45.11: Renal dialysis status
- V45.3: Intestinal bypass or anastomosis status
- V58.11: Encounter for antineoplastic chemotherapy
- V58.69: Long-term current use of other medications
Payment Basics:
There are articles on how to code and bill for tests that are covered by medicare, sample letters to send to the appeal board requesting reimbursement, and checklists for every single CPT code, including 0185U, 0186U, and 0187U. Providers talk about coding and billing like one would discuss property taxes or political campaigns; it’s an overwhelming topic but also a system where the rules are routinely undermined for those in the know.
Search for Get Medicare billing update instantly:
Get the latest Medicare billing news, reimbursement articles and download sample appeal letters for medically unnecessary denials.
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Conclusion:
As Medicare rules and regulations change from year to year, providers must be alert to the requirements and avail themselves of tools to ensure proper billing and maximum reimbursement.