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Our Vitamin D Assay Testing medical policy 746 describes our coverage for this test, including medical necessity requirements for repeat testing.
Starting on January 1, 2024, we’ll add frequency claim edits to reinforce our existing policy. This will help us process your claims upfront, reducing the number of claims that need post-payment review.
Once a patient (member) is identified as having a vitamin D deficiency, further testing may be considered medically necessary to ensure there has been adequate replacement. If the patient is not vitamin D deficient, repeat testing is not medically necessary, and the next time we would cover a test would be 12 months from the original test.
Thank you for helping our members to avoid additional costs by ordering covered tests.
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