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Your claims for Vitamin D testing
November 28, 2023

This article is for:

  • Primary care providers and other clinicians who order vitamin D tests
  • Clinical and hospital laboratories that conduct these tests.

Please share with your biller or billing agency.

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.

When is repeat testing medically necessary and not medically necessary?

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

Thank you for helping our members to avoid additional costs by ordering covered tests.