Wiki Vitamin D Testing

[akoschoff]

What diagnoses are people using in order to get CPTs 82306/82652 paid?

Where I work, Blue Cross has a list of medically necessary diagnoses but they put the cost to patient responsibility. I have also heard that Moda/ODS does not pay for this CPT either.

To avoid excess answers, we cannot use fatigue as a diagnosis.

Thanks in advance.

 

[mwallace29]

What diagnoses are people using in order to get CPTs 82306/82652 paid?

Where I work, Blue Cross has a list of medically necessary diagnoses but they put the cost to patient responsibility. I have also heard that Moda/ODS does not pay for this CPT either.

To avoid excess answers, we cannot use fatigue as a diagnosis.

Thanks in advance.

What about E55.9

 

[akoschoff]

We are trying to figure out which codes to use to determine whether it will be a provider write off or a transfer to patient responsibility.
The codes we have include those that are related to metabolism/malabsorption, vitamin D deficient, osteoporosis, osteomalacia, kidney/ureter calculi, hypoparathyroidism.

For example, if a patient comes in for fatigue, depression and their vitamin D level comes back within normal range, what code would you put on that?

 

[mitchellde]

I would use the Z03.89 for condition ruled out. It is not screening because the patient was symptomatic, you do not have a diagnosis rather you have that the provider has now ruled out a particular diagnosis.

 

[akoschoff]

Z03.89 is not considered a medically necessary diagnosis per the list we have for Blue Cross.