Billing Beat

Vitamin B12 Reimbursement Policy Update

January 3, 2007

Effective for dates of service on or after January 01, 2007, CPT-4 code 82607 [vitamin B-12]) is reimbursable only when billed in conjunction with one or more of the following ICD-9 codes. Reimbursement continues to be restricted to three tests per year for the same recipient by the same provider, unless medical justification is entered in the Remarks area/Reserved for Local Use field (Box 19) of the claim or submitted as an attachment.

ICD-9 Code Description
123.4 Diphyllobothriasis, intestinal
151.0 – 151.9 Malignant neoplasm of stomach
266.2 Other B-complex deficiencies
281.0 Pernicious anemia
281.1 Other vitamin B-12 deficiency anemia
281.3 Other specified megaloblastic anemias not elsewhere classified
281.9 Unspecified deficiency anemia
289.8 Other specified diseases of blood and blood-forming organs
290.0 – 290.9 Dementias
294.1 Dementia in conditions classified elsewhere
294.8 Other persistent mental disorders due to conditions classified elsewhere
294.9 Unspecified persistent mental disorders due to conditions classified elsewhere
310.0 Frontal lobe syndrome
356.9 Hereditary and idiopathic peripheral neuropathy; unspecified
357.4 Polyneuropathy in other diseases classified elsewhere
529.6 Glossodynia
535.10 – 535.11 Atrophic gastritis without mention of hemorrhage; Atrophic gastritis with hemorrhage
555.0 – 555.9 Regional enteritis
564.2 Postgastric surgery syndromes
577.1 Chronic pancreatitis
579.0 – 579.9 Intestinal malabsorption
751.1 Atresia and stenosis of small intestine
780.7 Malaise and fatigue
782.0 Disturbance of skin sensation
V44.2 Ileostomy
V44.4 Other artificial opening of gastrointestinal tract
V45.3 Intestinal bypass or anastomosis status
V45.89 Other

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