Humana Commercial – Vitamin D Testing Limitations

Effective date: 12/30/2021
Category: CPT – Lab / Pathology

What is changing.

We do not reimburse charges for the following CPT codes if a charge is not submitted with an approved diagnosis shown in Humana’s medical coverage policy:

• 82306 – Vitamin D; 25 hydroxy, includes fraction(s), if performed
• 82652 – Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed
• 0038U – Vitamin D; 25 hydroxy D2 and D3, by LC-MS/MS, serum microsample, quantitative
• According to Humana medical coverage policy, vitamin D testing is reimbursable only for certain conditions.
• Note: For additional information, refer to the Humana Medical and Pharmacy Coverage Policy page, and search by keywords “vitamin D testing.”
• Limit reimbursement for the following vitamin D testing CPT codes to no more than two times in any 12-month period. Exception: This frequency limit does not apply to vitamin D testing for patients with chronic kidney disease (CKD), end stage renal disease (ESRD) or intestinal malabsorption.