Vitamin D testing

Screen at-risk patients for vitamin D deficiency—now with expanded Medicare coverage

The Endocrine Society recommends regular vitamin D screening for individuals at risk for deficiency.

In accordance with these guidelines, private payers and Medicare offer coverage for patients with conditions that put them at risk for deficiency, including obesity, osteoporosis, and long-term treatment with corticosteroids and anti-seizure medications.

In some jurisdictions (e.g., Florida, Pennsylvania, the Southwest region), Medicare coverage includes testing up to 3 times per year.

In most jurisdictions, Medicare has expanded coverage for vitamin D testing for at-risk patients who have a BMI ≥30. When ordering tests for these patients, use the correct ICD-10 codes to support accurate payment and reduce disruptions. For obesity, these are Z68.30–Z68.45. Review our Medicare Coverage and Coding Guide for more information.

Two vitamin D [25-hydroxyvitamin D or 25(OH)D] testing methods from Quest Diagnostics

Quest offers two methods of vitamin D [25(OH)D] testing that can help you regularly assess at-risk patients, identify vitamin D deficiency and disorders, and manage deficiency once diagnosed.

Immunoassay:

  • Provides reliable results suitable for most patients and situations
  • Has fast turnaround times, with results available the day after specimen submission
  • Can be reported at the same time as many other tests
  • Reports total 25(OH)D concentration without differentiating D2 and D3

Liquid chromatography, tandem mass spectrometry (LC/MS/MS):

  • Reliable reference method results
  • Differentiates D2 and D3 and reports their concentrations along with the total 25(OH)D concentration
  • Differentiates the contribution of vitamin D2 and vitamin D3 supplementation

Note: 1,25(OH)2D measurement does not reflect vitamin D status. Measurement of 1,25(OH)2D is useful only in acquired and inherited disorders in the metabolism of 25(OH)D and phosphate, including chronic kidney disease.1

Quest vitamin D testing options

* The diagnosis code information is provided as a convenience to physicians and office staff. Diagnosis codes must be applicable to the patient's symptoms or conditions and must be consistent with documentation in the patient's medical record. Quest Diagnostics does not recommend any diagnosis codes and will only submit diagnosis information provided by the ordering physician, or his/her designated staff.

 

Screening at-risk patients for vitamin D deficiency

Visit our test center for more information about Quest’s vitamin D testing:

Vitamin D, 25-Hydroxy, Total, Immunoassay

QuestAssureD™ 25-Hydroxyvitamin D, LC/MS/MS

QuestAssureD™ for Infants, 25-Hydroxyvitamin D, LC/MS/MS

References

1. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrin Metab. 2011;96:1911-1930.

2. Holick MF, 2007 Vitamin D deficiency. N Engl J Med. 357:266-281.

3. Ginde AA, Liu MC, Camargo CA, et al. Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch Intern Med. 2009;169:626-632.

4. Kumar J, Muntner P, Kaskel FJ, et al. Prevalence and associations of 25-hydroxyvitamin D deficiency in US children: NHANES 2001–2004. Pediatrics. 2009;124:e362-e370.

5. Lai JK, Lucas RM, Clements MS, et al. Assessing vitamin D status: pitfalls for the unwary. Mol Nutr Food Res. 2010;54:1062-1071.

6. Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. In: Larsen PR, Kronenberg HM, Melmed S, Polonsky KS, eds. Williams Textbook of Endocrinology. 10th ed. Philadelphia, PA: WB Saunders; 2003:1303-1371.

7. St-Arnaud R, Glorieux FH. Hereditary defects in vitamin D metabolism and action. In: DeGroot LJ, Jameson JL, et al, eds. Endocrinology. 4th ed. Philadelphia, PA: WB Saunders; 2001:1154-1168.

8. Goldring SR, Krane SM, Avioli LV. Disorders of calcification: osteomalacia and rickets. In: DeGroot LJ, Jameson JL, et al, eds. Endocrinology. 4th ed. Philadelphia, PA: WB Saunders; 2001:1223-1243.