Posted in Insurance, Training, Updates

1199 SEIU Benefits Fund-Vitamin D testing – 09/01/2020

In order to ensure that 1199 SEIU Benefits Fund members get the proper medically necessary care, 1199 SEIU has implemented a new Vitamin D testing policy.

This policy will become effective 09/01/2020- 1199 SEIU Benefits Fund will pay for VITAMIN D testing for the following indications:

  • Medical Diagnosis associated with Vitamin D deficiency
  • Documented Vitamin D deficiency
  • Known or suspected excessive Vitamin D blood levels

Vitamin D testing is NOT considered medically necessary for the following:

  • Routine Preventative Screening test
  • All other indications

Coding and Billing:

The following Codes will be accepted:

82306- vitamin D; 25 hydroxy, includes fractions, if performed

82652- Vitamin D; 1,25 dihydroxy, includes fraction (s), if performed

Claims that are submitted with BOTH codes in combination, on the same day, are considered not medically necessary and will be denied.

In addition, code 0038U is currently not covered.

If providers have any questions regarding this policy, they can contact the 1199 SEIU Benefits Fund Provider Relations Department at 646-473-7160, Monday through Friday, from 9:00 AM to 5:00 PM.

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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