Vitamin D Testing

Coverage decision

Vitamin D testing is not covered as a part of routine screening.

Vitamin D testing requires prior authorization, and is covered benefit in individuals with the following conditions that are accepted on the claim:

  • A disease or condition known to cause, or be caused by, Vitamin D abnormality; or
  • Radiologic or laboratory findings positive for markers of Vitamin D abnormality; including specifically:
    • *blind loop syndrome
    • *celiac disease
    • chronic kidney disease
    • end stage renal disease
    • hypervitaminosis D
    • hypo or hypercalcemia
    • hypocalcemia and hypomagnesmia of newborn
    • hypoparathyroidism
    • secondary hyperparathyroidism
    • hypophosphatemia
    • intestinal malabsorption
    • osteomalacia
    • osteopetrosis
    • pancreatic steatorrhea
    • rickets
    • rickets/osteomalacia

*Covered only after diagnosis is established

Background Policy Information

The State Health Technology Clinical Committee (HTCC) reviewed Vitamin D testing on September 21, 2012. The committee’s determination, based on a systematic review of the evidence of safety, efficacy and cost-effectiveness, is that Vitamin D testing is a covered benefit with conditions consistent with the criteria identified in the reimbursement determination. Complete information on this HTCC determination is available here: http://www.hta.hca.wa.gov/vitamin_d.html

Implementation of this Determination

Beginning July 15, 2013 all requests for Vitamin D testing require prior authorization and will be reviewed by claims manager for State Fund Claims.

For State Fund Claims

By phone: To get the claims manager’s phone number, call the Claim Information line (1-800-831-5227)

By secure email: If you are the attending physician, IME, or concurrent care provider, log into to the Claims & Account Center (CAC)

For Crime Victims

Please contact the nurse consultant by one of the following modes of transmission: fax to (360) 902-5333 or call (360) 902-4896.

For Self-Insured Claims

For self-insured claims, contact the self-insured employer (SIE) or their third party administrator (TPA). For a list of SIE/TPAs, go to: http://www.lni.wa.gov/ClaimsIns/Insurance/SelfInsure/EmpList/FindEmps/Default.asp

Billing Codes

CPT ® Code
82306 - Assay of Vitamin D
82652 - Assay of Dihydroxy-Vitamin D

 


For more information:
Contact information.

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