Hello,
Was wondering if anyone had additional information on CMS policy and guidelines for Vitamin D re frequency? We have received some denials from Univera and they are denying 82306 for frequency, we contacted them and requested their policy and they advised that even though we are ordering the test with payable dx it is only allowed once a year and because we already tested we are maxed unless pt is Vitamin D deficient then they advise it can be billed as necessary till levels are adequate or stable. I have read Medicare policy several times and see no indication from CMS that we can only do this test yearly.The way I intereperet the policy is any dx listed on the LCD is payable if it meets medical necessity ,and indication as to why the test is being ordered. Not sure where Univera is getting that this test can only be done yearly.We have appealed and they have upheld. Any thoughts or information would be great.
Was wondering if anyone had additional information on CMS policy and guidelines for Vitamin D re frequency? We have received some denials from Univera and they are denying 82306 for frequency, we contacted them and requested their policy and they advised that even though we are ordering the test with payable dx it is only allowed once a year and because we already tested we are maxed unless pt is Vitamin D deficient then they advise it can be billed as necessary till levels are adequate or stable. I have read Medicare policy several times and see no indication from CMS that we can only do this test yearly.The way I intereperet the policy is any dx listed on the LCD is payable if it meets medical necessity ,and indication as to why the test is being ordered. Not sure where Univera is getting that this test can only be done yearly.We have appealed and they have upheld. Any thoughts or information would be great.