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Medical Policy Revision: Vitamin D Testing

Effective June 15, 2016, Horizon Blue Cross Blue Shield of New Jersey will change the way we consider certain claims for testing vitamin D levels in patients with or without signs/symptoms of vitamin D deficiency or toxicity.

According to the guidelines of our Vitamin D Testing medical policy, testing vitamin D levels in asymptomatic patients is not considered medically necessary unless the patient:

  • Has risk factors for vitamin D deficiency
  • Resides at long-term facility where some degree of medical care is provided (including long-term hospital stays, nursing homes, assisted living facilities and similar environments)

We encourage you to review this policy in our online Medical Policy Manual.

Based on the guidelines of our medical policy, Vitamin D Testing, and the submitted diagnosis code(s):

  • CPT® codes 82306 or 82652 submitted on claims for services provided on and after June 15, 2016 may be denied as not medically necessary.

Unless Horizon BCBSNJ gives written notice that all or part of the above changes have been cancelled or postponed, the changes will be applied to claims for dates of service on and after June 15, 2016.

CPT® is a registered mark of the American Medical Association.

Published on: March 17, 2016, 15:00 p.m. ET
Last updated on: December 7, 2020, 00:14 a.m. ET