Local Coverage Article Billing and Coding

Billing and Coding: Assays for Vitamins and Metabolic Function

A56485

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Article ID
A56485
Article Title
Billing and Coding: Assays for Vitamins and Metabolic Function
Article Type
Billing and Coding
Original Effective Date
04/11/2019
Revision Effective Date
10/01/2020
Revision Ending Date
N/A
Retirement Date
N/A
AMA CPT / ADA CDT / AHA NUBC Copyright Statement

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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Copyright © 2013 - 2021, the American Hospital Association, Chicago, Illinois. Reproduced by CMS with permission. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816. Making copies or utilizing the content of the UB-04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association. To license the electronic data file of UB-04 Data Specifications, contact Tim Carlson at (312) 893-6816. You may also contact us at ub04@aha.org.

CMS National Coverage Policy

Title XVIII of the Social Security Act, §1833(e) prohibits Medicare payment for any claim lacking the necessary documentation to process the claim.

Article Guidance

Article Text

The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Assays for Vitamins and Metabolic Function L33418.

The following are pertinent laboratory tests for which frequency limitations will be specified [note this should be all the CPT® codes in the list below, except for those that are non-covered]:

  • Vitamins and metabolic function assays: 25-OH Vitamin D-3, Carnitine, Vitamin B-12, Folic Acid (Serum), Homocystine, Vitamin B-6, Vitamin B-2, Vitamin B-1, Vitamin E, Fibrinogen, High-Sensitivity C-Reactive Protein and Lipoprotein-associated phospholipase A 2 (Lp-PLA 2); Vitamin A; Vitamin K; and Ascorbic acid.
  • Additional inclusion of Vitamin D (with limited coverage not otherwise specified).

Coding Information

CPT/HCPCS Codes

Group 1

Group 1 Paragraph

Note: Providers are reminded to refer to the long descriptors of the CPT® codes in their CPT® book. The American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) require the use of short CPT® descriptors in policies published on the Web.

Note: Code 82306 includes fractions, if performed.

Note: Code 82652 includes fractions, if performed.

 

Group 1 Codes
CodeDescription
82180 Assay of ascorbic acid
82306 Vitamin d 25 hydroxy
82379 Assay of carnitine
82607 Vitamin b-12
82652 Vit d 1 25-dihydroxy
82746 Assay of folic acid serum
83090 Assay of homocystine
83698 Assay lipoprotein pla2
84207 Assay of vitamin b-6
84252 Assay of vitamin b-2
84425 Assay of vitamin b-1
84446 Assay of vitamin e
84590 Assay of vitamin a
84591 Assay of nos vitamin
84597 Assay of vitamin k
85385 Fibrinogen antigen
86141 C-reactive protein hs
86352 Cell function assay w/stim
86353 Lymphocyte transformation

CPT/HCPCS Modifiers

N/A

ICD-10-CM Codes that Support Medical Necessity

Group 1

Group 1 Paragraph

Note: Providers should continue to submit ICD-10-CM diagnosis codes without decimals on their claim forms and electronic claims.

The CPT/HCPCS codes included in this article will be subjected to “procedure to diagnosis” editing. The following lists include only those diagnoses for which the identified CPT/HCPCS procedures are covered. If a covered diagnosis is not on the claim, the edit will automatically deny the service as not medically necessary.

Medicare is establishing the following limited coverage for CPT® codes 82306 and 82652:

Group 1 Codes
CodeDescription
E20.0 Idiopathic hypoparathyroidism
E20.8 Other hypoparathyroidism
E20.9 Hypoparathyroidism, unspecified
E21.0 Primary hyperparathyroidism
E21.1 Secondary hyperparathyroidism, not elsewhere classified
E21.2 Other hyperparathyroidism
E21.3 Hyperparathyroidism, unspecified
E55.0 Rickets, active
E55.9 Vitamin D deficiency, unspecified
E83.30 Disorder of phosphorus metabolism, unspecified
E83.31 Familial hypophosphatemia
E83.32 Hereditary vitamin D-dependent rickets (type 1) (type 2)
E83.39 Other disorders of phosphorus metabolism
E83.51 Hypocalcemia
E83.52 Hypercalcemia
E89.2 Postprocedural hypoparathyroidism
K91.1 Postgastric surgery syndromes
K91.2 Postsurgical malabsorption, not elsewhere classified
K91.81 Other intraoperative complications of digestive system
M81.0 Age-related osteoporosis without current pathological fracture
M81.6 Localized osteoporosis [Lequesne]
M81.8 Other osteoporosis without current pathological fracture
M83.0 Puerperal osteomalacia
M83.1 Senile osteomalacia
M83.2 Adult osteomalacia due to malabsorption
M83.3 Adult osteomalacia due to malnutrition
M83.4 Aluminum bone disease
M83.5 Other drug-induced osteomalacia in adults
M83.8 Other adult osteomalacia
M83.9 Adult osteomalacia, unspecified
M85.811 Other specified disorders of bone density and structure, right shoulder
M85.812 Other specified disorders of bone density and structure, left shoulder
M85.821 Other specified disorders of bone density and structure, right upper arm
M85.822 Other specified disorders of bone density and structure, left upper arm
M85.831 Other specified disorders of bone density and structure, right forearm
M85.832 Other specified disorders of bone density and structure, left forearm
M85.841 Other specified disorders of bone density and structure, right hand
M85.842 Other specified disorders of bone density and structure, left hand
M85.851 Other specified disorders of bone density and structure, right thigh
M85.852 Other specified disorders of bone density and structure, left thigh
M85.861 Other specified disorders of bone density and structure, right lower leg
M85.862 Other specified disorders of bone density and structure, left lower leg
M85.871 Other specified disorders of bone density and structure, right ankle and foot
M85.872 Other specified disorders of bone density and structure, left ankle and foot
M85.88 Other specified disorders of bone density and structure, other site
M85.9 Disorder of bone density and structure, unspecified
M89.9 Disorder of bone, unspecified
M94.9 Disorder of cartilage, unspecified
N18.30 Chronic kidney disease, stage 3 unspecified
N18.31 Chronic kidney disease, stage 3a
N18.32 Chronic kidney disease, stage 3b
N18.4 Chronic kidney disease, stage 4 (severe)
N18.5 Chronic kidney disease, stage 5
N18.6 End stage renal disease
N25.81 Secondary hyperparathyroidism of renal origin

Group 2

Group 2 Paragraph

Medicare is establishing the following limited coverage for CPT® code 82379:

Group 2 Codes
CodeDescription
D63.1 Anemia in chronic kidney disease
E71.40 Disorder of carnitine metabolism, unspecified
E71.41 Primary carnitine deficiency
E71.42 Carnitine deficiency due to inborn errors of metabolism
E71.43 Iatrogenic carnitine deficiency
E71.440 Ruvalcaba-Myhre-Smith syndrome
E71.448 Other secondary carnitine deficiency
I95.3 Hypotension of hemodialysis

Group 3

Group 3 Paragraph

Medicare is establishing the following limited coverage for CPT® codes 82607, 82746 and 83090:

Group 3 Codes
CodeDescription
D51.0 Vitamin B12 deficiency anemia due to intrinsic factor deficiency
D51.1 Vitamin B12 deficiency anemia due to selective vitamin B12 malabsorption with proteinuria
D51.2 Transcobalamin II deficiency
D51.3 Other dietary vitamin B12 deficiency anemia
D51.8 Other vitamin B12 deficiency anemias
D51.9 Vitamin B12 deficiency anemia, unspecified
D52.0 Dietary folate deficiency anemia
D52.1 Drug-induced folate deficiency anemia
D52.8 Other folate deficiency anemias
D52.9 Folate deficiency anemia, unspecified
D53.1 Other megaloblastic anemias, not elsewhere classified
D53.9 Nutritional anemia, unspecified
D69.6 Thrombocytopenia, unspecified
D70.0 Congenital agranulocytosis
D70.1 Agranulocytosis secondary to cancer chemotherapy
D70.2 Other drug-induced agranulocytosis
D70.3 Neutropenia due to infection
D70.4 Cyclic neutropenia
D70.8 Other neutropenia
D70.9 Neutropenia, unspecified
D71 Functional disorders of polymorphonuclear neutrophils
D72.0 Genetic anomalies of leukocytes
D72.10 Eosinophilia, unspecified
D72.110 Idiopathic hypereosinophilic syndrome [IHES]
D72.118 Other hypereosinophilic syndrome
D72.119 Hypereosinophilic syndrome [HES], unspecified
D72.12 Drug rash with eosinophilia and systemic symptoms syndrome
D72.18 Eosinophilia in diseases classified elsewhere
D72.19 Other eosinophilia
D72.810 Lymphocytopenia
D72.818 Other decreased white blood cell count
D72.819 Decreased white blood cell count, unspecified
D76.1 Hemophagocytic lymphohistiocytosis
D76.2 Hemophagocytic syndrome, infection-associated
D76.3 Other histiocytosis syndromes
D81.818 Other biotin-dependent carboxylase deficiency
D81.819 Biotin-dependent carboxylase deficiency, unspecified
E41 Nutritional marasmus
E43 Unspecified severe protein-calorie malnutrition
E44.0 Moderate protein-calorie malnutrition
E45 Retarded development following protein-calorie malnutrition
E46 Unspecified protein-calorie malnutrition
E53.8 Deficiency of other specified B group vitamins
E64.0 Sequelae of protein-calorie malnutrition
E72.10 Disorders of sulfur-bearing amino-acid metabolism, unspecified
E72.11 Homocystinuria
E72.12 Methylenetetrahydrofolate reductase deficiency
E72.19 Other disorders of sulfur-bearing amino-acid metabolism
F03.90 Unspecified dementia without behavioral disturbance
F10.11 Alcohol abuse, in remission
F10.130 Alcohol abuse with withdrawal, uncomplicated
F10.131 Alcohol abuse with withdrawal delirium
F10.132 Alcohol abuse with withdrawal with perceptual disturbance
F10.139 Alcohol abuse with withdrawal, unspecified
F10.20 Alcohol dependence, uncomplicated
G25.70 Drug induced movement disorder, unspecified
G25.71 Drug induced akathisia
G25.79 Other drug induced movement disorders
G25.89 Other specified extrapyramidal and movement disorders
G25.9 Extrapyramidal and movement disorder, unspecified
G26 Extrapyramidal and movement disorders in diseases classified elsewhere
G30.0 Alzheimer's disease with early onset
G30.1 Alzheimer's disease with late onset
G30.8 Other Alzheimer's disease
G30.9 Alzheimer's disease, unspecified
G60.3 Idiopathic progressive neuropathy
G60.9 Hereditary and idiopathic neuropathy, unspecified
K14.0 Glossitis
K14.6 Glossodynia
K31.83 Achlorhydria
K50.00 Crohn's disease of small intestine without complications
K50.011 Crohn's disease of small intestine with rectal bleeding
K50.012 Crohn's disease of small intestine with intestinal obstruction
K50.013 Crohn's disease of small intestine with fistula
K50.014 Crohn's disease of small intestine with abscess
K50.018 Crohn's disease of small intestine with other complication
K50.019 Crohn's disease of small intestine with unspecified complications
K50.10 Crohn's disease of large intestine without complications
K50.111 Crohn's disease of large intestine with rectal bleeding
K50.112 Crohn's disease of large intestine with intestinal obstruction
K50.113 Crohn's disease of large intestine with fistula
K50.114 Crohn's disease of large intestine with abscess
K50.118 Crohn's disease of large intestine with other complication
K50.119 Crohn's disease of large intestine with unspecified complications
K50.80 Crohn's disease of both small and large intestine without complications
K50.811 Crohn's disease of both small and large intestine with rectal bleeding
K50.812 Crohn's disease of both small and large intestine with intestinal obstruction
K50.813 Crohn's disease of both small and large intestine with fistula
K50.814 Crohn's disease of both small and large intestine with abscess
K50.818 Crohn's disease of both small and large intestine with other complication
K50.819 Crohn's disease of both small and large intestine with unspecified complications
K50.90 Crohn's disease, unspecified, without complications
K50.911 Crohn's disease, unspecified, with rectal bleeding
K50.912 Crohn's disease, unspecified, with intestinal obstruction
K50.913 Crohn's disease, unspecified, with fistula
K50.914 Crohn's disease, unspecified, with abscess
K50.918 Crohn's disease, unspecified, with other complication
K50.919 Crohn's disease, unspecified, with unspecified complications
K52.21 Food protein-induced enterocolitis syndrome
K52.22 Food protein-induced enteropathy
K52.29 Other allergic and dietetic gastroenteritis and colitis
K52.3 Indeterminate colitis
K52.831 Collagenous colitis
K52.832 Lymphocytic colitis
K58.1 Irritable bowel syndrome with constipation
K58.2 Mixed irritable bowel syndrome
K90.0 Celiac disease
K90.1 Tropical sprue
K90.2 Blind loop syndrome, not elsewhere classified
K90.3 Pancreatic steatorrhea
K90.81 Whipple's disease
K90.89 Other intestinal malabsorption
K90.9 Intestinal malabsorption, unspecified
K91.1 Postgastric surgery syndromes
K91.2 Postsurgical malabsorption, not elsewhere classified
K91.30 Postprocedural intestinal obstruction, unspecified as to partial versus complete
K91.31 Postprocedural partial intestinal obstruction
K91.32 Postprocedural complete intestinal obstruction
K91.81 Other intraoperative complications of digestive system
R20.0 Anesthesia of skin
R20.1 Hypoesthesia of skin
R20.2 Paresthesia of skin
R20.3 Hyperesthesia
R20.8 Other disturbances of skin sensation
R20.9 Unspecified disturbances of skin sensation
R26.0 Ataxic gait
R26.1 Paralytic gait
R26.81 Unsteadiness on feet
R26.89 Other abnormalities of gait and mobility
R26.9 Unspecified abnormalities of gait and mobility
R27.0 Ataxia, unspecified
R27.8 Other lack of coordination
R27.9 Unspecified lack of coordination
R41.1 Anterograde amnesia
R41.2 Retrograde amnesia
R41.3 Other amnesia
R41.9 Unspecified symptoms and signs involving cognitive functions and awareness
R45.84 Anhedonia
R68.89 Other general symptoms and signs
Z51.11 Encounter for antineoplastic chemotherapy
Z79.3 Long term (current) use of hormonal contraceptives
Z79.891 Long term (current) use of opiate analgesic
Z79.899 Other long term (current) drug therapy
Z86.2 Personal history of diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism
Z86.31 Personal history of diabetic foot ulcer
Z86.32 Personal history of gestational diabetes
Z86.39 Personal history of other endocrine, nutritional and metabolic disease
Z98.0 Intestinal bypass and anastomosis status
Z99.2 Dependence on renal dialysis

Group 4

Group 4 Paragraph

Medicare is establishing the following limited coverage for CPT® code 84207:

Group 4 Codes
CodeDescription
D64.0 Hereditary sideroblastic anemia
D64.1 Secondary sideroblastic anemia due to disease
D64.2 Secondary sideroblastic anemia due to drugs and toxins
D64.3 Other sideroblastic anemias
E53.1 Pyridoxine deficiency
G25.70 Drug induced movement disorder, unspecified
G25.71 Drug induced akathisia
G25.79 Other drug induced movement disorders
G25.89 Other specified extrapyramidal and movement disorders
G26 Extrapyramidal and movement disorders in diseases classified elsewhere
G57.83 Other specified mononeuropathies of bilateral lower limbs
G57.93 Unspecified mononeuropathy of bilateral lower limbs
G60.9 Hereditary and idiopathic neuropathy, unspecified
G61.82 Multifocal motor neuropathy
K14.0 Glossitis
K90.9 Intestinal malabsorption, unspecified
K91.1 Postgastric surgery syndromes
K91.2 Postsurgical malabsorption, not elsewhere classified
K91.81 Other intraoperative complications of digestive system
R74.8 Abnormal levels of other serum enzymes

Group 5

Group 5 Paragraph

Medicare is establishing the following limited coverage for CPT® code 85385:

Group 5 Codes
CodeDescription
D47.3 Essential (hemorrhagic) thrombocythemia
D65 Disseminated intravascular coagulation [defibrination syndrome]
D68.2 Hereditary deficiency of other clotting factors
D68.32 Hemorrhagic disorder due to extrinsic circulating anticoagulants
D68.4 Acquired coagulation factor deficiency
D69.3 Immune thrombocytopenic purpura
D69.41 Evans syndrome
D69.42 Congenital and hereditary thrombocytopenia purpura
D69.49 Other primary thrombocytopenia
D69.51 Posttransfusion purpura
D69.59 Other secondary thrombocytopenia
D69.6 Thrombocytopenia, unspecified
R79.1 Abnormal coagulation profile

Group 6

Group 6 Paragraph

Medicare is establishing the following limited coverage for CPT® codes 86352 and 86353:

Group 6 Codes
CodeDescription
D81.4 Nezelof's syndrome
D82.0 Wiskott-Aldrich syndrome
D82.1 Di George's syndrome
D83.1 Common variable immunodeficiency with predominant immunoregulatory T-cell disorders
J63.2 Berylliosis
T86.00 Unspecified complication of bone marrow transplant
T86.01 Bone marrow transplant rejection
T86.02 Bone marrow transplant failure
T86.03 Bone marrow transplant infection
T86.09 Other complications of bone marrow transplant
T86.10 Unspecified complication of kidney transplant
T86.11 Kidney transplant rejection
T86.12 Kidney transplant failure
T86.13 Kidney transplant infection
T86.19 Other complication of kidney transplant
T86.20 Unspecified complication of heart transplant
T86.21 Heart transplant rejection
T86.22 Heart transplant failure
T86.23 Heart transplant infection
T86.290 Cardiac allograft vasculopathy
T86.298 Other complications of heart transplant
T86.30 Unspecified complication of heart-lung transplant
T86.31 Heart-lung transplant rejection
T86.32 Heart-lung transplant failure
T86.33 Heart-lung transplant infection
T86.39 Other complications of heart-lung transplant
T86.40 Unspecified complication of liver transplant
T86.41 Liver transplant rejection
T86.42 Liver transplant failure
T86.43 Liver transplant infection
T86.49 Other complications of liver transplant
T86.5 Complications of stem cell transplant
T86.810 Lung transplant rejection
T86.811 Lung transplant failure
T86.812 Lung transplant infection
T86.818 Other complications of lung transplant
T86.819 Unspecified complication of lung transplant
T86.850 Intestine transplant rejection
T86.851 Intestine transplant failure
T86.852 Intestine transplant infection
T86.858 Other complications of intestine transplant
T86.859 Unspecified complication of intestine transplant
T86.890 Other transplanted tissue rejection
T86.891 Other transplanted tissue failure
T86.899 Unspecified complication of other transplanted tissue
Z13.83 Encounter for screening for respiratory disorder NEC
Z48.21 Encounter for aftercare following heart transplant
Z48.22 Encounter for aftercare following kidney transplant
Z48.23 Encounter for aftercare following liver transplant
Z48.24 Encounter for aftercare following lung transplant
Z48.280 Encounter for aftercare following heart-lung transplant
Z48.290 Encounter for aftercare following bone marrow transplant
Z77.018 Contact with and (suspected) exposure to other hazardous metals
Z94.0 Kidney transplant status
Z94.1 Heart transplant status
Z94.2 Lung transplant status
Z94.3 Heart and lungs transplant status
Z94.4 Liver transplant status
Z94.81 Bone marrow transplant status
Z94.82 Intestine transplant status
Z94.83 Pancreas transplant status

Group 7

Group 7 Paragraph

Medicare is establishing the following limited coverage for CPT® code 86141 and 83698:

Group 7 Codes
CodeDescription
I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris
I25.110 Atherosclerotic heart disease of native coronary artery with unstable angina pectoris
I25.111 Atherosclerotic heart disease of native coronary artery with angina pectoris with documented spasm
I25.118 Atherosclerotic heart disease of native coronary artery with other forms of angina pectoris
I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris
I25.84 Coronary atherosclerosis due to calcified coronary lesion
I70.0 Atherosclerosis of aorta
I70.1 Atherosclerosis of renal artery
I70.201 Unspecified atherosclerosis of native arteries of extremities, right leg
I70.202 Unspecified atherosclerosis of native arteries of extremities, left leg
I70.203 Unspecified atherosclerosis of native arteries of extremities, bilateral legs
I70.208 Unspecified atherosclerosis of native arteries of extremities, other extremity
I70.209 Unspecified atherosclerosis of native arteries of extremities, unspecified extremity
I70.211 Atherosclerosis of native arteries of extremities with intermittent claudication, right leg
I70.212 Atherosclerosis of native arteries of extremities with intermittent claudication, left leg
I70.213 Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs
I70.218 Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity
I70.219 Atherosclerosis of native arteries of extremities with intermittent claudication, unspecified extremity
I70.221 Atherosclerosis of native arteries of extremities with rest pain, right leg
I70.222 Atherosclerosis of native arteries of extremities with rest pain, left leg
I70.223 Atherosclerosis of native arteries of extremities with rest pain, bilateral legs
I70.228 Atherosclerosis of native arteries of extremities with rest pain, other extremity
I70.229 Atherosclerosis of native arteries of extremities with rest pain, unspecified extremity
I70.231 Atherosclerosis of native arteries of right leg with ulceration of thigh
I70.232 Atherosclerosis of native arteries of right leg with ulceration of calf
I70.233 Atherosclerosis of native arteries of right leg with ulceration of ankle
I70.234 Atherosclerosis of native arteries of right leg with ulceration of heel and midfoot
I70.235 Atherosclerosis of native arteries of right leg with ulceration of other part of foot
I70.238 Atherosclerosis of native arteries of right leg with ulceration of other part of lower leg
I70.239 Atherosclerosis of native arteries of right leg with ulceration of unspecified site
I70.241 Atherosclerosis of native arteries of left leg with ulceration of thigh
I70.242 Atherosclerosis of native arteries of left leg with ulceration of calf
I70.243 Atherosclerosis of native arteries of left leg with ulceration of ankle
I70.244 Atherosclerosis of native arteries of left leg with ulceration of heel and midfoot
I70.245 Atherosclerosis of native arteries of left leg with ulceration of other part of foot
I70.248 Atherosclerosis of native arteries of left leg with ulceration of other part of lower leg
I70.249 Atherosclerosis of native arteries of left leg with ulceration of unspecified site
I70.25 Atherosclerosis of native arteries of other extremities with ulceration
I70.261 Atherosclerosis of native arteries of extremities with gangrene, right leg
I70.262 Atherosclerosis of native arteries of extremities with gangrene, left leg
I70.263 Atherosclerosis of native arteries of extremities with gangrene, bilateral legs
I70.268 Atherosclerosis of native arteries of extremities with gangrene, other extremity
I70.269 Atherosclerosis of native arteries of extremities with gangrene, unspecified extremity
I70.291 Other atherosclerosis of native arteries of extremities, right leg
I70.292 Other atherosclerosis of native arteries of extremities, left leg
I70.293 Other atherosclerosis of native arteries of extremities, bilateral legs
I70.298 Other atherosclerosis of native arteries of extremities, other extremity
I70.299 Other atherosclerosis of native arteries of extremities, unspecified extremity
I70.301 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, right leg
I70.302 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, left leg
I70.303 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, bilateral legs
I70.308 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, other extremity
I70.309 Unspecified atherosclerosis of unspecified type of bypass graft(s) of the extremities, unspecified extremity
I70.311 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, right leg
I70.312 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, left leg
I70.313 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, bilateral legs
I70.318 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, other extremity
I70.319 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, unspecified extremity
I70.321 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, right leg
I70.322 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, left leg
I70.323 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, bilateral legs
I70.328 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, other extremity
I70.329 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with rest pain, unspecified extremity
I70.331 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of thigh
I70.332 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of calf
I70.333 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of ankle
I70.334 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of heel and midfoot
I70.335 Atherosclerosis of unspecified type of bypass graft(s) of the right leg with ulceration of other part of foot
I70.8 Atherosclerosis of other arteries
I70.90 Unspecified atherosclerosis
I70.91 Generalized atherosclerosis
I70.92 Chronic total occlusion of artery of the extremities

Group 8

Group 8 Paragraph

Medicare is establishing the following limited coverage for CPT® code 83698:

Group 8 Codes
CodeDescription
E11.10 Type 2 diabetes mellitus with ketoacidosis without coma
E11.11 Type 2 diabetes mellitus with ketoacidosis with coma
E11.65 Type 2 diabetes mellitus with hyperglycemia
E11.9 Type 2 diabetes mellitus without complications
E13.9 Other specified diabetes mellitus without complications
E78.00 Pure hypercholesterolemia, unspecified
E78.01 Familial hypercholesterolemia
E78.1 Pure hyperglyceridemia
E78.2 Mixed hyperlipidemia
E78.3 Hyperchylomicronemia
E78.41 Elevated Lipoprotein(a)
E78.49 Other hyperlipidemia
E78.5 Hyperlipidemia, unspecified

ICD-10-CM Codes that DO NOT Support Medical Necessity

N/A

Additional ICD-10 Information

N/A

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

N/A

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.

CodeDescription
0999 Patient Convenience Items - Other Convenience Items

Other Coding Information

N/A

Revision History Information

Revision History DateRevision History NumberRevision History Explanation
10/01/2020 R5

Under ICD-10 Codes that Support Medical Necessity Group 1: Codes deleted N18.3 and added N18.30, N18.31 and N18.32. Under ICD-10 Codes that Support Medical Necessity Group 3: Codes deleted D72.1 and added D72.10, D72.110, D72.118, D72.119, D72.12, D72.18, D72.19, F10.130, F10.131, F10.132 and F10.139. CPT® was inserted throughout the article where applicable. Typographical errors were corrected throughout the article. This revision is due to the Annual ICD-10 Code Update and is effective on 10/1/20.

10/10/2019 R4

This article is being revised in order to adhere to CMS requirements per Chapter 13, Section 13.5.1 of the Program Integrity Manual, to remove all coding from LCDs and incorporate into related Billing and Coding Articles. Title XVIII of the Social Security Act, §1833(e) was removed from the CMS National Coverage Policy section of the related Assays for Vitamins and Metabolic Function L33418 LCD and placed in this article.

10/01/2019 R3

Under Article Text added second paragraph. Under Revenue Codes added code 0999. This code was inadvertently left off with revision 1.

Under Covered ICD-10 Codes Group 7: Codes the description changed for ICD-10 codes I70.238 and I70.248. This revision is due to the 2019 Annual ICD-10 Code Update and will become effective on October 1, 2019.

04/11/2019 R2

Typographical error corrected.

04/11/2019 R1

All coding located in the Coding Information section has been removed from the related Assays for Vitamins and Metabolic Function L33418 Local Coverage Determination (LCD) and added to this article.

 

Associated Documents

Related Local Coverage Documents
LCDs
L33418 - Assays for Vitamins and Metabolic Function
Related National Coverage Documents
N/A
Statutory Requirements URLs
N/A
Rules and Regulations URLs
N/A
CMS Manual Explanations URLs
N/A
Other URLs
N/A
Public Versions
Updated On Effective Dates Status
09/08/2020 10/01/2020 - N/A Currently in Effect You are here
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • Assays for Vitamins
  • Vitamins
  • Metabolic Function