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Revision To Local Coverage Determination (LCD): Vitamin D; 25 Hydroxy, Includes Fraction(s)

LCD ID number: L33771 Based on a reconsideration request, the local coverage determination (LCD) for vitamin D; 25 hydroxy, includes fraction(s), if performed was revised to add multiple indications to the Indications and Limitations of Coverage
and/or Medical Necessity section of the LCD.

In addition, based on change request (CR) 8776 the Centers for Medicare & Medicaid Services (CMS) made operational changes to billing lab tests for separate payment. Therefore, the vitamin D; 25 hydroxy, includes fraction(s), if performed LCD was revised to remove
language related to lab services and type of bill (TOB) 13x under the “CPT®/HCPCS Codes” section of the LCD.

The following are the supporting ICD-10-CM codes:

  • A15.0—A19.9, B38.1
  • B38.9, B39.1— B39.9,
  • C82.00— C82.99,
  • D80.0— D80.9, D86.0— D86.9, D89.810— D89.813,
  • E67.8, E68, E83.59,
  • E84.0, E84.19— E84.8,
  • G73.7,
  • J63.2,
  • K50.00— K51.319, K51.50—K52.0, K74.1, K74.2, K83.8, K86.0— K86.1, K86.81— K86.89, K87, K90.81,
  • L40.0— L40.9,
  • M32.0— M32.9, M33.00— M33.99, M36.0, M60.80— M60.9, M79.1, M79.7, M81.6, M85.80,
  • Q78.0, Q78.2,
  • Z68.30-Z68.45, Z79.3, Z79.51—Z79.52, Z79.891—Z79.899, Z98.0, and Z98.84.

    Effective Date: The LCD revision related to the addition of multiple indications is effective for services rendered on or after June 22, 2017. This LCD revision related to lab services and TOB 13x is effective for claims processed on or after May 12, 2017, for services rendered on or after January 1, 2014.