Assays for Vitamins and Metabolic Function

Medicare covers targeted, single vitamin assays when reasonable and necessary for diagnosis or treatment of a specific, documented vitamin deficiency or in patients with conditions predisposing to deficiency; general multi-vitamin panels and routine screening are non-covered. Specific assays listed in the policy are subject to diagnosis-to-procedure mappings and frequency limitations (see Utilization Guidelines and companion Billing and Coding article A56416), and claims are subject to post-payment review and audits.

"Targeted single vitamin assays are covered when reasonable and necessary for diagnosis or treatment of a specific suspected vitamin deficiency documented by history and focused physical exam."

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