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Update on appropriate use of vitamin D testing

April 29, 2016

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Vitamin D, also known as calciferol, is a fat-soluble vitamin that has a variety of physiologic effects, most prominently in calcium homeostasis and bone metabolism. Providers are reminded that there should be a direct medical need or indication for testing of vitamin D serum levels. Therefore, routine testing for vitamin D deficiency in healthy adults and children is not indicated according to evidence-based reviews or clinical practice guidelines from organizations that include, but are not limited to, the U.S. Preventive Services Task Force.

Vitamin D testing

In order to communicate the medically necessary uses for vitamin D testing, AmeriHealth has developed new commercial and Medicare Advantage policies. These policies will be posted as Notifications on May 3, 2016, and will become effective on August 1, 2016:

  • Commercial: #06.02.51: Testing Serum Vitamin D Levels
  • Medicare Advantage: #MA06.031: Vitamin D Assay Testing
To view the Notifications for these policies, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online. Then select either Commercial or Medicare Advantage under Active Notifications.

When clinically appropriate, AmeriHealth-participating laboratories are capable of performing vitamin D testing. If you have any questions about participating laboratories, please contact your Provider Partnership Associate or Network Coordinator.

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