Vitamin B12 Reimbursement Policy Update
January 3, 2007Effective 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 |