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Vitamin D CPT Code (2022) Description, Guidelines, Reimbursement, Modifiers & Example
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Vitamin D CPT code 82306 or 82652, bills for the service when the Physician performs a Vitamin D test; 25 hydroxy, or 1, 25 di-hydroxy, which includes fraction(s). The Physician requests a test to measure the vitamin D level via blood sample in the body and the body’s ability to store it.
Vitamin D CPT Code Description
The following are the reasons why the Physician performs a Vitamin D test:
- Fractures
- Bone weakness
- Having a darker complexion
- Congenital bones Malformation
- Obesity
- Osteoporosis or other bone disorder
- Vitamin D deficiency
- Age-related osteoporosis or other bone disorder
- Lack of exposure to sunlight
It also may perform on patients with psoriasis, asthma, and autoimmune diseases.
The Physician may perform 1,25 (OH) Vitamin D, 1,25-Dihydroxy Vitamin D, 1,2 Dihydroxy-cholecalciferol, and 1,25-Dihydroxy. It represents the most active form of 1,25 (OH) Vitamin D, 1,25-Dihydroxy Vitamin D, 1,25-Dihydroxycholecalciferal, and 1,25-Dihydroxy.
Vitamin D produces by the renal cell and has a significant role in Calcium absorption. The Physician may take a sample in the form of serum or absorption by either radioimmunoassay (RIA) or column chromatography.CPT codes 82306 and 82652 include fractions if furnished by the physicians
CPT 82306
CPT 82306 bills for the service when the Physician performs Vitamin D; 25 hydroxy, which includes fraction(s).
CPT 82652
CPT 82652 bills for the service when the Physician performs Vitamin D; 1, 25 di-hydroxy, which includes fraction(s).
Vitamin D CPT Code Billing Guidelines
Documentation should support the medical necessity of service. It reflects that service is medically necessary and appropriate.
The following are the most used payable dx codes for Vitamin D CPT code 82306 or 82652:
D86.0, D86.1, D86.2, D86.3, D86.81, D86.82, D86.83, D86.84, D86.85, D86.86, D86.87, D86.89, D86.9, E20.0, E20.1, E20.8, E20.9, E21.0, E21.1, E21.2, E21.3, E55.0, E83.59, E89.2, L40.0, L40.1, L40.4, L40.8, L40.9, M62.84, M80.0AXA, M80.8AXA, M81.0, M81.6, M81.8, M83.0, M83.1, M83.2, M83.3, M83.4, M83.5, M83.8, M83.9, N25.0, Z00.00, and Z01..812.
Vitamin D CPT code 82306 or 82652, includes the following components:
Clinical information does not provide by the ordering physician, and Mathematical calculated results, Quantitative analysis unless otherwise specified, Specimens from any source unless otherwise specified, Analyses from nonrequested laboratory analysis, and Calculated results representing score or probability derived by the algorithm.
If Drug testing (80324, 80325, 80326, 80327, 80305, 80306, 80348, 80349, 80350, 80351, 80307, 80366, 80367, 80368, 80369, 80370, 80329, 80330, 80331, 80332, 80358, 80359, 80360, 80361, 80362, 80363, 80364, 8036580338, 80339, 80340, 80341, 80342, 80328, , 80346, 80347, 80352, 80353, 80354, 80355, 80356, 80357, 80371, 80372, 80373, 80374, 80333, 80334, 80335, 80336, 80337, 80375, 80376, 80377, 83992, 80343, 80344, 80345) performs in combination with CPT 82306, or 82652, It is appropriate to report separately. Check with payer guidelines if modifier is appropriate.
If Organ or disease panels (80048-80076, 80081) perform in combination with CPT 82306, or 82652, It is appropriate to report separately. Check with payer guidelines if the modifier is relevant.
If Therapeutic drug assays (80150-80299, 80164, 80165, 80171) performs in combination with CPT 82306, or 82652, It is appropriate to report separately. Check with payer guidelines if the modifier is relevant.
If Evaluation and management service(99202-9999) performs in addition to the chest-Xray, It is appropriate to report CPT code 82306 or 82652 separately.
Vitamin D CPT Code Modifiers
The following are the list modifiers when Vitamin D CPT code 82306 or 82652 bills:
22, 23, 52, 58, 59, 76, 77, 78, 79, 90, 91 AI, AQ, AR, CC, CR, ET, EY, FX, FY, GA, GC, GK, GR, GU, GY, GZ, KX, PT, Q5, Q6, QJ, SG, TC, XR, XP, XU, XS.
Modifier 90 is applicable with CPT 82306, or 82652, when service performs by a party other than the treating or reporting Physician to repeat the same laboratory test on the same day to obtain subsequent (multiple) test results.
Modifier 91 is applicable with Vitamin D CPT code 82306 or 82652 when service performs by a Physician or other qualified health care professional.
Modifier 76 is applicable with CPT 82306, or 82652, when a similar service performs by the Same Physician on the same day.
Modifier 77 is applicable with CPT 82306, or 82652, when a similar service performs by a different Physician on the same service date.
Modifier 59 is applicable with Vitamin D CPT code 82306, or 82652, when a Distinct service performs by the Physician and bundled with another procedure on the same date.
Modifier X {E, P, S, U} is applicable instead of Modifier 59 with 82306, or 82652 when service bills to Medicare insurance. It divides the modifier into four parts for further specification of the procedure.
If physicians believe that Medicare will deny such service, reporting with a GA modifier is appropriate. The beneficiary must sign an Advance Beneficiary Notification (ABN), and 82306, or 82652, must apply the GA modifier to that service.
Modifier 52 is applicable when the Physician cannot complete the procedure due to unavoidable circumstances.
Vitamin D CPT Code Reimbursement
A maximum of one unit can be a bill on the same service date of CPT 82306, or 82652. In contrast, the three units allow when documentation supports the medical necessity of the service.
The cost of CPT 82306 is $29.60 when performed in the facility. In contrast, the reimbursement of 82306, or 82652 with modifier 26 is 29.60 when performed in the non-facility.
The cost of Vitamin D CPT code 82652 is $38.50 when performed in the facility. In contrast, the reimbursement of 82306, or 82652 with modifier 26 is $38.50 when performed in the non-facility.
Vitamin D CPT Code Examples
The following are the example when Vitamin D CPT code 82306 or 82652 bills:
Example 1
A 25-year-old female presents with muscle weakness for seven days. She did not take any medication for the itching site. She had sex with a stranger person eight days ago.
The physical exam revealed swelling in the upper and lower extremity. The Physician ordered an X-ray of the upper and lower extremity.
It shows no skin infections around the female genital organs. The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath.
The Physician advises the patient to take preventive action and exercise in the morning—the orders the Vitamin D test to determine the vitamin D deficiency.
Example 2
A thirty-year-old female presents with osteoarthritis of knee and ankle joints. The patient developed inflammation of the joints and took some medication for pain.
The physical exam revealed swelling in the upper and lower extremity. The Physician ordered an X-ray of the upper and lower extremity.
It shows no skin infections around the female genital organs. The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath.
The Physician advises the patient to take preventive action and exercise in the morning—the orders the Vitamin D test to determine the vitamin D deficiency.
Example 3
A 25-year-old female presents with obesity and has pain in the extremities. She did not take any medication for pain. Currently, She is eating unhealthy food in larger quantities.
The physical exam revealed swelling in the upper and lower extremity. The Physician ordered an X-ray of the upper and lower extremity.
It shows no skin infections around the female genital organs. The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath.
The Physician advises the patient to take preventive action and exercise in the morning—the order the Vitamin D test to determine the vitamin D deficiency.
Example 4
A 27-year-old male presents with multiple fractures at the hip, ankle, and knee joint. He is following proper exercise and diet. It frequently happens with the patient.
The physical exam revealed swelling in the upper and lower extremity. The Physician ordered an X-ray of the upper and lower extremity.
It shows no skin infections around the female genital organs. The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath.
The Physician advises the patient to take preventive action and exercise in the morning—the orders the Vitamin D test to determine the vitamin D deficiency.
Example 5
A 29-year-old female presents with muscle weakness and body aches. She has less exposure to sunlight and does not take an adequate diet or any medication for the pain.
The physical exam revealed swelling in the upper and lower extremity. The Physician ordered an X-ray of the upper and lower extremity.
It shows no skin infections around the female genital organs. The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath.
The Physician advises the patient to take preventive action and exercise in the morning—the orders the Vitamin D test to determine the vitamin D deficiency.
Example 6
A thirty-year-old female presents to the office with a darker skin complexion and not applying any cream on the skin. The patient is eating a healthy diet, and no other issue identify in the encounter.
The physical exam revealed no swelling in the upper and lower extremity. The Physician ordered an X-ray of the pelvis and labs test for gonorrhea infection.
It shows no skin infections around the female genital organs. The patient denies any other symptoms such as headache, numbness, urinary problems, nausea, vomiting, and shortness of breath.
The Physician advises the patient to take preventive action and exercise in the morning—the orders the Vitamin D test to determine the vitamin D deficiency.
This content may be outdated
This article was published more than 1 year ago. While we strive to keep our content up to date, medical coding guidelines and regulations may have changed since then.
