Quest Diagnostics 82652 Vitamin Screening and Testing User Guide
- June 14, 2024
- Quest Diagnostics
Table of Contents
**Quest Diagnostics 82652 Vitamin Screening and Testing User Guide
**
Vitamin D Screening and Testing Policy, Professional
IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY
You are responsible for submission of accurate claims. This reimbursement policy is intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. Washington Medicaid reimbursement policies uses Current Procedural Terminology (CPT®*), Centers for Medicare and Medicaid Services (CMS) or other coding guidelines. References to CPT or other sources are for definitional purposes only and do not imply any right to reimbursement.
This reimbursement policy applies to all health care services billed on CMS 1500 forms and, when specified, to those billed on UB04 forms. Coding methodology, industry-standard reimbursement logic, regulatory requirements, benefits design and other factors are considered in developing reimbursement policy.
This information is intended to serve only as a general reference resource regarding Washington Medicaid’s reimbursement policy for the services described and is not intended to address every aspect of a reimbursement situation. Accordingly, Washington Medicaid may use reasonable discretion in interpreting and applying this policy to health care services provided in a particular case. Further, the policy does not address all issues related to reimbursement for health care services provided to Washington Medicaidenrollees.
Other factors affecting reimbursement supplement, modify or, in some cases, supersede this policy. These factors include but are not limited to: federal &/or state regulatory requirements, the physician or other provider contracts, the enrollee’s benefit coverage documents, and/or other reimbursement, medical or drug policies.
Finally, this policy may not be implemented exactly the same way on the different electronic claims processing systems used by Washington Medicaid due to programming or other constraints; however, Washington Medicaid strives to minimize these variations.
Washington Medicaid may modify this reimbursement policy at any time by publishing a new version of the policy on this Website. However, the information presented in this policy is accurate and current as of the date of publication.
*CPT Copyright American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association.
Application
This reimbursement policy applies to services reported using the 1500 Health Insurance Claim Form (a/k/a CMS-1500) or its electronic equivalent or its successor form. This policy applies to all products and all network and non- network physicians and other qualified health care professionals, including, but not limited to, non-network authorized and percent of charge contract physicians and other qualified health care professionals.
Visit : QuestDiagnostics.com/commercialcoverage to view additional commercial insurance limited coverage tests, reference guides, and policy information.
Policy
Reimbursement Guidelines
Routine Vitamin D screening for the general population (CPT codes 82306, 82652) is not considered medically necessary.
Vitamin D testing (25-hydroxy vitamin D, calcidiol, CPT code 82306) may be considered medically necessary for the following conditions:
-
Chronic kidney disease stage 3 or greater
-
End stage renal disease
-
Evaluation of hypo- or hypercalcemia
-
Hypocalcemia and hypomagnesemia of newborn
-
Hypophosphatemia
-
Hypoparathyroidism
-
Intestinal malabsorption including:
✓ Blind loop syndrome
✓ Celiac disease
✓ Pancreatic Steatorrhea -
Secondary hyperparathyroidism
-
Hypervitaminosis D
-
Osteomalacia
-
Osteopenia
-
Rickets
-
In the setting of other laboratory or imaging indicators of vitamin D deficiency for:
✓ Calculus of kidney or ureter
✓ Chronic liver disease in the absences of alcohol dependency
✓ Protein-calorie malnutrition
Vitamin D testing (25-dihydroxy vitamin D, calcitriol, CPT 82652) may be considered medically necessary as a second-tier test for the following conditions:
- Disorders of calcium metabolism
- Familial hypophosphatemia
- Fanconi syndrome
- Hypoparathyroidism or hyperparathyroidism
- Vitamin D resistant rickets
- Tumor induced osteomalacia
- Sarcoidosis
Disclaimer :
This diagnosis code reference guide is provided as an aid to physicians and
office staff to help inform you of the limited coverage policy.
Diagnosis codes must be applicable to the patient’s symptoms or conditions and
must be consistent with documentation in the patient’s medical record. Quest
Diagnostics does not recommend any diagnosis codes and will only submit
diagnosis information provided to us by the ordering physician or his/her
designated staff. The CPT codes provided are based on AMA guidelines and are
for informational purposes only. CPT coding is the sole responsibility of the
billing party. Please direct any questions regarding coding to the payer being
billed. Please see the payer’s full vitamin D coverage policy for a complete
list of references.
Disclaimer : QuestDiagnostics.com
Quest, Quest Diagnostics, any associated logos, and all associated Quest
Diagnostics registered or unregistered trademarks are the property of Quest
Diagnostics. All third-party marks—® and ™—are the property of their
respective owners. © 2018 Quest Diagnostics Incorporated. All rights reserved.
Last updated : 03/08/24