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Vitamin D Testing

Blue Cross & Blue Shield of Mississippi·MS · Family Medicine, Internal Medicine, Endocrinology +5 more·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

This policy establishes coverage criteria for vitamin D testing, allowing up to 4 tests per calendar year for specific high-risk conditions but excluding routine screening in asymptomatic patients. The policy was recently reviewed with no changes on 03/27/2025.

Action Required

Action needed
Immediately: Billing team must ensure vitamin D testing claims include appropriate diagnosis codes from the covered conditions list and limit testing to maximum 4 times per calendar year per patient. Update billing edits to flag routine screening vitamin D tests in asymptomatic patients as non-covered. Train staff to verify medical necessity documentation supports one of the specified qualifying conditions before submitting claims.

Affected Billing Codes

C96.20
C96.21
C96.22
C96.29
M33.03
M33.13
M33.93
M33.00
M33.09
M33.10
M33.19
E72.89
M79.10
M79.18
E70.89
N18.30
N18.31
N18.32
E20.810
E20.811
E20.812
E20.818
E20.819
E20.89
K90.821
K90.822
K90.829
K90.83
Q98.0
Q98.1
Q98.2
Q98.3
Q98.4
C86.00
C86.01
C86.10
C86.20
C86.21
C86.30
C86.31
C86.40
C86.41
C86.50
C86.51
C86.60
C88.40