Pathology/Lab Coding Alert

Question: A physician ordered a test for serum Calcidiol D2 and D3, which our lab performed using LC-MS/MS. I can't find Calcidiol listed in the code book. How should we code this test?

Arkansas Subscriber

Answer: Calcidiol is an older name for 25-hydroxy vitamin D. The correct code for the test is 82306 (Vitamin D; 25 hydroxy, includes fraction(s), if performed). Because the code states, "includes fraction(s), if performed," you should report just one unit of 82306 even though the lab analyses for 25 hydroxy vitamin D2 and D3.

Clinicians often request this test to help diagnose vitamin D deficiency or monitor vitamin D replacement therapy in patients with a diagnosed deficiency. Physicians may also order the test to assist in distinguishing the cause of rickets or osteomalacia.

Don't confuse 82306 with the code for 1, 25 dihydroxy vitamin D, also known as Calcitriol, which is 82652 (Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed). Physicians more often order this as a secondary test to assess vitamin D status. For instance, a physician might request this test for patients with kidney disease or to help distinguish vitamin D deficiency from hypercalcemia.