Notification



Notification Issue Date:



Medicare Advantage Policy

Title:Vitamin D Assay Testing
Policy #:MA06.031c

This policy is applicable to the Company’s Medicare Advantage products only. Policies that are applicable to the Company’s commercial products are accessible via a separate commercial policy database.


The Company makes decisions on coverage based on the Centers for Medicare and Medicaid Services (CMS) regulations and guidance, benefit plan documents and contracts, and the member’s medical history and condition. If CMS does not have a position addressing a service, the Company makes decisions based on Company Policy Bulletins. Benefits may vary based on contract, and individual member benefits must be verified. The Company determines medical necessity only if the benefit exists and no contract exclusions are applicable. Although the Medicare Advantage Policy Bulletin is consistent with Medicare’s regulations and guidance, the Company’s payment methodology may differ from Medicare.

When services can be administered in various settings, the Company reserves the right to reimburse only those services that are furnished in the most appropriate and cost-effective setting that is appropriate to the member’s medical needs and condition. This decision is based on the member’s current medical condition and any required monitoring or additional services that may coincide with the delivery of this service.


This Policy Bulletin document describes the status of CMS coverage, medical terminology, and/or benefit plan documents and contracts at the time the document was developed. This Policy Bulletin will be reviewed regularly and be updated as Medicare changes their regulations and guidance, scientific and medical literature becomes available, and/or the benefit plan documents and/or contracts are changed.



Policy

Coverage is subject to the terms, conditions, and limitations of the member's Evidence of Coverage.

MEDICALLY NECESSARY INDICATIONS

Vitamin D, 25 hydroxy or 1, 25 dihydroxy, assay testing is considered medically necessary and, therefore, covered for individuals with the following indications per the frequency limits listed in this policy section:
  • Chronic kidney disease stage III or greater 
  • Cirrhosis 
  • Fibromyalgia 
  • Granuloma forming diseases 
  • Hypocalcemia 
  • Hypercalcemia 
  • Hypovitaminosis D 
  • Hypervitaminosis D 
  • Long-term use of anticonvulsants or glucocorticoids and other medications known to lower vitamin D levels 
  • Malabsorption states 
  • Obstructive jaundice 
  • Osteomalacia 
  • Osteoporosis 
  • Osteogenesis imperfecta 
  • Osteosclerosis 
  • Psoriasis 
  • Rickets 
  • Vitamin D deficiency on replacement therapy; to monitor the efficacy of treatment

MEDICALLY NECESSARY FREQUENCIES

Testing of 25 hydroxy Vitamin D (CPT Code 82306), including fraction(s) is considered medically necessary and, therefore, covered for for up to three (3) times per year for the ICD-10-CM codes listed under the CPT Code 82306 in the coding table of this policy with the following exception:
  • ICD-10-CM codes, E55.0, E55.9, M83.0-M83.5, M83.8, M83.9, which are covered for up to four (4) times per year.

Testing of 1, 25 dihydroxy Vitamin D (CPT Code 82652), including fraction(s) is considered medically necessary and, therefore, covered for for up to two (2) times per year for the ICD-10-CM codes listed under the CPT Code 82652 in the coding table of this policy with the following exception:
  • ICD-10-CM code, E55.0, which is covered for up to four (4) times per year.

Only one 25 hydroxy Vitamin D or only one 1, 25 dihydroxy Vitamin D level will be reimbursed in any 24 hour period, if medically necessary. Storage and supplement components will not be reimbursed separately. 

NOT MEDICALLY NECESSARY

All other uses, including routine screening, for Vitamin D assay testing are considered not medically necessary and, therefore, not covered.

REQUIRED DOCUMENTATION

The individual's medical record must reflect the medical necessity for the care provided. These medical records may include, but are not limited to: records from the professional provider's office, hospital, nursing home, home health agencies, therapies, and test reports.

The Company may conduct reviews and audits of services to our members, regardless of the participation status of the provider. All documentation is to be available to the Company upon request. Failure to produce the requested information may result in a denial for the service.
Policy Guidelines

This policy is consistent with Medicare’s coverage determination. The Company’s payment methodology may differ from Medicare.

Description

Vitamin D is called a "vitamin" because of its exogenous source, predominately from oily fish in the form of vitamin D2 and vitamin D3. It is more accurate to consider fat-soluble Vitamin D as a steroid hormone, synthesized by the skin and metabolized by the kidney to an active hormone, calcitriol. Clinical disorders related to vitamin D may arise because of altered availability of the parent vitamin D, altered conversion of vitamin D to its predominant metabolites, altered organ responsiveness to dihydroxylated metabolites and disturbances in the interactions of the vitamin D metabolites with PTH and calcitonin.

All assays of vitamin D and its metabolites need not be performed for each of the clinically warranted indications. Often, one type is more appropriate for a certain disease state than another. The most common type of vitamin D deficiency is that of 25 hydroxy (OH) vitamin D. A much smaller percentage of 1, 25 dihydroxy vitamin D deficiency exists; mostly in those with renal disease.
References

Al Aly Z, et al. Changes in serum 25-hydroxyvitamin D and plasma intact PTH levels following treatment with ergocalciferol in patients with CKD. Am. J. Kidney Dis. 2007;50(1):59-68.

American Gastroenterological Association medical position statement: guidelines on osteoporosis in gastrointestinal diseases. Gastroenterology 2003;124:791.

American Medical Association (AMA). Council on Science and Public Health. Appropriate supplementation of vitamin D. CSAPH Report 4-A-09. Available at http://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-science-public-health/reports/2009-reports.page?. Accessed May 2, 2016.

Armas LAG, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab.2004;89(11):5387-5391.

Autier P, Gandini S. Vitamin D Supplementation and total mortality. A meta-analysis of randomized controlled trials. Arch Intern Med. 2007;167(16);1730-1737.

Bernstein, CN, Leslie, WD, Leboff, MS. AGA technical review on osteoporosis in gastrointestinal diseases. Gastroenterology 2003;124:795.

Buischoff-Ferrari, HA et al Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes Am J Clin Nutr. 2006;84:18.

Burtis WJ , Wu TL, Insogna, KL, et al. Humoral hypercalcemia of malignancy. Ann Intern Med 1988;08:454.

Ceglia L. Vitamin D and skeletal muscle tissue and function. Mol Aspects Med. 2008;29(6):407-14. Epub 2008 Aug 8. Review.

Clinician’s Guide to Prevention and Treatment of Osteoporosis, National Osteoporosis Foundation. Available at http://link.springer.com/article/10.1007/s00198-014-2794-2. Accessed May 2, 2016.

Collins, N, Maher, J, Cole, M, et al. A prospective study to evaluate the dose of vitamin D required to correct low 25-hydroxyvitamin D levels, calcium, and alkaline phosphatase in patients at risk of developing antiepileptic drug-induced osteomalacia. Q J Med 1991; 78:113.

Compston, JE. Hepatic osteodystrophy: Vitamin D metabolism in patients with liver disease. Gut 1986; 27:1073.

Dibble JB, Sheridan P, Losowsky, MS. A survey of vitamin D deficiency in gastrointestinal and liver disorders. Q J Med 1984; 53:119.

Donovan DS, Papadopoulos A, Staron RB, et al. Bone mass and vitamin D deficiency in adults with advanced cystic fibrosis lung disease. Am J Respir Crit Care Med 1998; 157:1892.

El-Hajj Fuleihan G, Nabulsi M, Tamim H, et al. Effect of vitamin D replacement on musculoskeletal parameters in school children: a randomized controlled trial. J Clin Endocrinol Metab. 2006 Feb;91(2):405-12. Epub 2005 Nov 8.

Ernst B, Thurnheer M, Schmid SM, et al. Seasonal variation in the deficiency of 25-hydroxyvitamin D(3) in mildly to extremely obese subjects. Obes Surg. 2009;19(2):180-3. Epub 2008 Jul 29.

Fitzpatrick, LA, Arnold, A. Hypoparathyroidism. In: Endocrinology, 3rd ed. DeGroot, LJ, (Ed), Saunders, Philadelphia 1995 p.1123.

Giovannucci E, Liu Y, Hollis BW, et al. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch InternMed..2008:168(11):1174-1180.

Gloth FM, Gundberg CM, Hollis BW, et al. Vitamin D deficiency in homebound elderly persons. JAMA 1995; 274:1683.

Goldner WS, Stoner JA, Thompson J, et al. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: a comparison with non-obese controls. Obes Surg. 2008 Feb;18(2):145-50.

Goldstein, DA, Haldimann, B, Sherman, D, et al. Vitamin D metabolites and calcium metabolism in patients with nephrotic syndrome and normal renal function. J Clin Endocrinol Metab 1981; 52:116.

Goltzman D, Cole, DEC. Hypoparathyroidism. In Primer on the Metabolic Bone Diseases and Disorders of Bone Metabolism. American Society of Bone and Mineral Research 2006; 6:216

Gordon PL, Sakkas GK, Doyle JW, et al. Relationship between vitamin D and muscle size and strength in patients on hemodialysis. J Ren Nutr. 2007 Nov;17(6):397-407.

Hahn, TJ. Drug-induced disorders of vitamin D and mineral metabolism. Clin Endocrinol Metab 1980; 9:107.

Holick, MF. Vitamin D deficiency. N Engl J Med 2007; 357:266.

Hollick MF High Prevalence of Vitamin D Inadequacy and Implications for Health Mayo Clin Proc. 2006;81(3):353-373.

Horwitz M, Hodak S, Stewart A. Non-Parathyroid Hypercalcemia. In: Primer on Metabolic Bone Diseases and Disorders of Mineral Metabolism. 7th ed., 2008:7:307-312.

Jacobus CH, Holick MF, Shao Q, et al. Hypervitaminosis D associated with drinking milk. N Engl J Med 1992; 326:1173.

Johnson JM, Maher JW, Demaria EJ, et al. The Long-term Effects of Gastric Bypass on Vitamin D Metabolism. Ann Surg 2006; 243:701.

Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Part A: vitamins. Obes Surg. 2008;18(7):870-6. Epub 2008 Mar 4. Review.

Kimball, S, Vieth, R. Self-prescribed high-dose vitamin D3: effects on biochemical parameters in two men. Ann Clin Biochem 2008;45:106.

Klein GL, Chen TC, Holick MF, et al. Synthesis of vitamin D in skin after burns. Lancet 2004;363:291.

Kumar, R. Hepatic and intestinal osteodystrophy and the hepatobiliary metabolism of vitamin D. Ann Intern Med. 1983;98:662.

Local Coverage Determination (LCD): Vitamin D Assay Testing (L34888):https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34888&ContrId=323&ver=6&ContrVer=1&Date=10%2f29%2f2015&DocID=L34888&bc=iAAAAAgAAAAAAA%3d%3d&. Accessed: 02/23/2016

Lafferty, FW. Differential diagnosis of hypercalcemia. J Bone Miner Res 1991; 6 Suppl 2:S51.

MacLaughlin, J, Holick, MF. Aging decreases the capacity of human skin to produce vitamin D3. J Clin Invest 1985; 76:1536.

Novitas Solutions Contractor Medical Directors.

O'Keefe JH, Carter MD, Lavie CJ. Primary and Secondary Prevention of Cardiovascular Diseases: A Practical Evidence-Based Approach. Mayo Clin Proc2009;84(8):741-757.

Other Contractor(s)' Policies.

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Second Edition. The American Society for Bone and Mineral Research, 1993, page 69.

Rosol, TJ, Capen, CC. Mechanisms of cancer-induced hypercalcemia. Lab Invest1992; 67:680.

Sánchez-Hernández J, Ybarra J, Gich I, et al. Effects of bariatric surgery on vitamin D status and secondary hyperparathyroidism: a prospective study.Obes Surg. 2005;15(10):1389-95.

Schilling, T, Pecherstorfer, M, Blind, E, et al. Parathyroid hormone-related protein (PTH-rP) does not regulate serum 1,25-dihydroxyvitamin D levels in hypercalcemia of malignancy. J Clin Endocrinol Metab 1993; 76:801.

Silverberg S, Bilezikian. Primary Hyperparathyroidism. In: Primer on Metabolic Bone Diseases and Disorders of Mineral Metabolism. 7th ed., 2008:7:302-306

Silverberg, S.J., et.al. The effects of vitamin D insufficiency in patients with primary hyperparathyroidism. Am. J. Med. 1999;107(6):561-567.

Sotaniemi EA, Hakkarainen HK, Puranen JA, et al. Radiologic bone changes and hypocalcemia with anticonvulsant therapy in epilepsy. Ann Intern Med.1972; 77:389.

The Journal of CliniLow Vitamin D Status, High Bone Turnover, and Bone Fractures in Centenarianscal Endocrinology & Metabolism 88(11):5109–5115, .

The Journal of Clinical Endocrinology & Metabolism, Vitamin D Insufficiency and Hyperparathyroidism in a Low Income, Multiracial, Elderly Population.

Tomida, K., et. al. Bone, (2008), "Serum 25-hydroxyvitamin D as an independent determinant of 1-84 PTH and bone mineral density in non-diabetic predialysis CKD patients"., Bone, (2008).

Välimäki, MJ, Tiihonen, M, Laitinen, K, et al. Bone mineral density measured by dual-energy X-ray absorptiometry and novel markers of bone formation and resorption in patients on antiepileptic drugs. J Bone Miner Res 1994; 9:631.

Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. [published correction appears in Pediatrics 2009;123;197.]. Pediatrics 2008;122;1142-1152.

Ward KA, Das G, Berry JL, et al. Vitamin D status and muscle function in post-menarchal adolescent girls. J Clin Endocrinol Metab. 2009 Feb;94(2):559-63. Epub 2008 Nov 25.

Webb, AR, Kline, L, Holick, MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: Exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 1988; 67:373.

Ybarra J, Sánchez-Hernández J, Pérez A. Hypovitaminosis D and morbid obesity. Nurs Clin North Am. 2007 Mar;42(1):19-27, v. Review.



Coding

Inclusion of a code in this table does not imply reimbursement. Eligibility, benefits, limitations, exclusions, precertification/referral requirements, provider contracts, and Company policies apply.

The codes listed below are updated on a regular basis, in accordance with nationally accepted coding guidelines. Therefore, this policy applies to any and all future applicable coding changes, revisions, or updates.

In order to ensure optimal reimbursement, all health care services, devices, and pharmaceuticals should be reported using the billing codes and modifiers that most accurately represent the services rendered, unless otherwise directed by the Company.

The Coding Table lists any CPT, ICD-9, ICD-10, and HCPCS billing codes related only to the specific policy in which they appear.

CPT Procedure Code Number(s)

0038U, 82306, 82652


Professional and outpatient claims with a date of service on or before September 30, 2015, must be billed using ICD-9 codes. Professional and outpatient claims with a date of service on or after October 1, 2015, must be billed using ICD-10 codes.

Facility/Institutional inpatient claims with a date of discharge on or before September 30, 2015, must be billed with ICD-9 codes. Facility/Institutional inpatient claims with a date of discharge on or after October 1, 2015, must be billed with ICD-10 codes.


ICD - 10 Procedure Code Number(s)

N/A


Professional and outpatient claims with a date of service on or before September 30, 2015, must be billed using ICD-9 codes. Professional and outpatient claims with a date of service on or after October 1, 2015, must be billed using ICD-10 codes.

Facility/Institutional inpatient claims with a date of discharge on or before September 30, 2015, must be billed with ICD-9 codes. Facility/Institutional inpatient claims with a date of discharge on or after October 1, 2015, must be billed with ICD-10 codes.


ICD -10 Diagnosis Code Number(s)

MEDICALLY NECESSARY FOR 82306

A15.0 Tuberculosis of lung

A15.4 Tuberculosis of intrathoracic lymph nodes

A15.5 Tuberculosis of larynx, trachea and bronchus

A15.6 Tuberculous pleurisy

A15.7 Primary respiratory tuberculosis

A15.8 Other respiratory tuberculosis

A15.9 Respiratory tuberculosis unspecified

A17.0 Tuberculous meningitis

A17.1 Meningeal tuberculoma

A17.81 Tuberculoma of brain and spinal cord

A17.82 Tuberculous meningoencephalitis

A17.83 Tuberculous neuritis

A17.89 Other tuberculosis of nervous system

A17.9 Tuberculosis of nervous system, unspecified

A18.01 Tuberculosis of spine

A18.02 Tuberculous arthritis of other joints

A18.03 Tuberculosis of other bones

A18.09 Other musculoskeletal tuberculosis

A18.10 Tuberculosis of genitourinary system, unspecified

A18.11 Tuberculosis of kidney and ureter

A18.12 Tuberculosis of bladder

A18.13 Tuberculosis of other urinary organs

A18.14 Tuberculosis of prostate

A18.15 Tuberculosis of other male genital organs

A18.16 Tuberculosis of cervix

A18.17 Tuberculous female pelvic inflammatory disease

A18.18 Tuberculosis of other female genital organs

A18.2 Tuberculous peripheral lymphadenopathy

A18.31 Tuberculous peritonitis

A18.32 Tuberculous enteritis

A18.39 Retroperitoneal tuberculosis

A18.4 Tuberculosis of skin and subcutaneous tissue

A18.50 Tuberculosis of eye, unspecified

A18.51 Tuberculous episcleritis

A18.52 Tuberculous keratitis

A18.53 Tuberculous chorioretinitis

A18.54 Tuberculous iridocyclitis

A18.59 Other tuberculosis of eye

A18.6 Tuberculosis of (inner) (middle) ear

A18.7 Tuberculosis of adrenal glands

A18.81 Tuberculosis of thyroid gland

A18.82 Tuberculosis of other endocrine glands

A18.83 Tuberculosis of digestive tract organs, not elsewhere classified

A18.84 Tuberculosis of heart

A18.85 Tuberculosis of spleen

A18.89 Tuberculosis of other sites

A19.0 Acute miliary tuberculosis of a single specified site

A19.1 Acute miliary tuberculosis of multiple sites

A19.2 Acute miliary tuberculosis, unspecified

A19.8 Other miliary tuberculosis

A19.9 Miliary tuberculosis, unspecified

D71 Functional disorders of polymorphonuclear neutrophils

D86.0 Sarcoidosis of lung

D86.1 Sarcoidosis of lymph nodes

D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes

D86.3 Sarcoidosis of skin

D86.81 Sarcoid meningitis

D86.82 Multiple cranial nerve palsies in sarcoidosis

D86.83 Sarcoid iridocyclitis

D86.84 Sarcoid pyelonephritis

D86.85 Sarcoid myocarditis

D86.86 Sarcoid arthropathy

D86.87 Sarcoid myositis

D86.89 Sarcoidosis of other sites

D86.9 Sarcoidosis, unspecified

E21.1 Secondary hyperparathyroidism, not elsewhere classified

E55.0 Rickets, active

E55.9 Vitamin D deficiency, unspecified

E67.2 Megavitamin-B6 syndrome

E67.3 Hypervitaminosis D

E67.8 Other specified hyperalimentation

E68 Sequelae of hyperalimentation

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

E83.59 Other disorders of calcium metabolism

G73.7 Myopathy in diseases classified elsewhere

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

K51.00 Ulcerative (chronic) pancolitis without complications

K51.011 Ulcerative (chronic) pancolitis with rectal bleeding

K51.012 Ulcerative (chronic) pancolitis with intestinal obstruction

K51.013 Ulcerative (chronic) pancolitis with fistula

K51.014 Ulcerative (chronic) pancolitis with abscess

K51.018 Ulcerative (chronic) pancolitis with other complication

K51.019 Ulcerative (chronic) pancolitis with unspecified complications

K51.20 Ulcerative (chronic) proctitis without complications

K51.211 Ulcerative (chronic) proctitis with rectal bleeding

K51.212 Ulcerative (chronic) proctitis with intestinal obstruction

K51.213 Ulcerative (chronic) proctitis with fistula

K51.214 Ulcerative (chronic) proctitis with abscess

K51.218 Ulcerative (chronic) proctitis with other complication

K51.219 Ulcerative (chronic) proctitis with unspecified complications

K51.30 Ulcerative (chronic) rectosigmoiditis without complications

K51.311 Ulcerative (chronic) rectosigmoiditis with rectal bleeding

K51.312 Ulcerative (chronic) rectosigmoiditis with intestinal obstruction

K51.313 Ulcerative (chronic) rectosigmoiditis with fistula

K51.314 Ulcerative (chronic) rectosigmoiditis with abscess

K51.318 Ulcerative (chronic) rectosigmoiditis with other complication

K51.319 Ulcerative (chronic) rectosigmoiditis with unspecified complications

K51.40 Inflammatory polyps of colon without complications

K51.411 Inflammatory polyps of colon with rectal bleeding

K51.412 Inflammatory polyps of colon with intestinal obstruction

K51.413 Inflammatory polyps of colon with fistula

K51.414 Inflammatory polyps of colon with abscess

K51.418 Inflammatory polyps of colon with other complication

K51.419 Inflammatory polyps of colon with unspecified complications

K51.50 Left sided colitis without complications

K51.511 Left sided colitis with rectal bleeding

K51.512 Left sided colitis with intestinal obstruction

K51.513 Left sided colitis with fistula

K51.514 Left sided colitis with abscess

K51.518 Left sided colitis with other complication

K51.519 Left sided colitis with unspecified complications

K51.80 Other ulcerative colitis without complications

K51.811 Other ulcerative colitis with rectal bleeding

K51.812 Other ulcerative colitis with intestinal obstruction

K51.813 Other ulcerative colitis with fistula

K51.814 Other ulcerative colitis with abscess

K51.818 Other ulcerative colitis with other complication

K51.819 Other ulcerative colitis with unspecified complications

K51.90 Ulcerative colitis, unspecified, without complications

K51.911 Ulcerative colitis, unspecified with rectal bleeding

K51.912 Ulcerative colitis, unspecified with intestinal obstruction

K51.913 Ulcerative colitis, unspecified with fistula

K51.914 Ulcerative colitis, unspecified with abscess

K51.918 Ulcerative colitis, unspecified with other complication

K51.919 Ulcerative colitis, unspecified with unspecified complications

K70.2 Alcoholic fibrosis and sclerosis of liver

K70.30 Alcoholic cirrhosis of liver without ascites

K70.31 Alcoholic cirrhosis of liver with ascites

K74.0 Hepatic fibrosis

K74.3 Primary biliary cirrhosis

K74.4 Secondary biliary cirrhosis

K74.5 Biliary cirrhosis, unspecified

K74.60 Unspecified cirrhosis of liver

K74.69 Other cirrhosis of liver

K83.5 Biliary cyst

K83.8 Other specified diseases of biliary tract

K87 Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere

K90.0 Celiac disease

K90.1 Tropical sprue

K90.2 Blind loop syndrome, not elsewhere classified

K90.3 Pancreatic steatorrhea

K90.4 Malabsorption due to intolerance, not elsewhere classified

K90.81 Whipple's disease

K90.89 Other intestinal malabsorption

K90.9 Intestinal malabsorption, unspecified

K91.2 Postsurgical malabsorption, not elsewhere classified

L40.0 Psoriasis vulgaris

L40.1 Generalized pustular psoriasis

L40.2 Acrodermatitis continua

L40.3 Pustulosis palmaris et plantaris

L40.4 Guttate psoriasis

L40.50 Arthropathic psoriasis, unspecified

L40.51 Distal interphalangeal psoriatic arthropathy

L40.52 Psoriatic arthritis mutilans

L40.53 Psoriatic spondylitis

L40.54 Psoriatic juvenile arthropathy

L40.59 Other psoriatic arthropathy

L40.8 Other psoriasis

L40.9 Psoriasis, unspecified

M32.0 Drug-induced systemic lupus erythematosus

M32.10 Systemic lupus erythematosus, organ or system involvement unspecified

M32.11 Endocarditis in systemic lupus erythematosus

M32.12 Pericarditis in systemic lupus erythematosus

M32.13 Lung involvement in systemic lupus erythematosus

M32.14 Glomerular disease in systemic lupus erythematosus

M32.15 Tubulo-interstitial nephropathy in systemic lupus erythematosus

M32.19 Other organ or system involvement in systemic lupus erythematosus

M32.8 Other forms of systemic lupus erythematosus

M32.9 Systemic lupus erythematosus, unspecified

M33.00 Juvenile dermatomyositis, organ involvement unspecified

M33.01 Juvenile dermatomyositis with respiratory involvement

M33.02 Juvenile dermatomyositis with myopathy

M33.03 Juvenile dermatomyositis without myopathy

M33.09 Juvenile dermatomyositis with other organ involvement

M33.10 Other dermatomyositis, organ involvement unspecified

M33.11 Other dermatomyositis with respiratory involvement

M33.12 Other dermatomyositis with myopathy

M33.13 Other dermatomyositis without myopathy

M33.19 Other dermatomyositis with other organ involvement

M33.20 Polymyositis, organ involvement unspecified

M33.21 Polymyositis with respiratory involvement

M33.22 Polymyositis with myopathy

M33.29 Polymyositis with other organ involvement

M33.90 Dermatopolymyositis, unspecified, organ involvement unspecified

M33.91 Dermatopolymyositis, unspecified with respiratory involvement

M33.92 Dermatopolymyositis, unspecified with myopathy

M33.93 Dermatopolymyositis, unspecified without myopathy

M33.99 Dermatopolymyositis, unspecified with other organ involvement

M36.0 Dermato(poly)myositis in neoplastic disease

M60.80 Other myositis, unspecified site

M60.811 Other myositis, right shoulder

M60.812 Other myositis, left shoulder

M60.819 Other myositis, unspecified shoulder

M60.821 Other myositis, right upper arm

M60.822 Other myositis, left upper arm

M60.829 Other myositis, unspecified upper arm

M60.831 Other myositis, right forearm

M60.832 Other myositis, left forearm

M60.839 Other myositis, unspecified forearm

M60.841 Other myositis, right hand

M60.842 Other myositis, left hand

M60.849 Other myositis, unspecified hand

M60.851 Other myositis, right thigh

M60.852 Other myositis, left thigh

M60.859 Other myositis, unspecified thigh

M60.861 Other myositis, right lower leg

M60.862 Other myositis, left lower leg

M60.869 Other myositis, unspecified lower leg

M60.871 Other myositis, right ankle and foot

M60.872 Other myositis, left ankle and foot

M60.879 Other myositis, unspecified ankle and foot

M60.88 Other myositis, other site

M60.89 Other myositis, multiple sites

M60.9 Myositis, unspecified

M79.10 Myalgia, unspecified site

M79.11 Myalgia of mastication muscle

M79.12 Myalgia of auxiliary muscles, head and neck

M79.18 Myalgia, other site

M79.7 Fibromyalgia

M80.00XA Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture

M80.00XD Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with routine healing

M80.00XG Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with delayed healing

M80.00XK Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with nonunion

M80.00XP Age-related osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with malunion

M80.00XS Age-related osteoporosis with current pathological fracture, unspecified site, sequela

M80.011A Age-related osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture

M80.011D Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with routine healing

M80.011G Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with delayed healing

M80.011K Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with nonunion

M80.011P Age-related osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with malunion

M80.011S Age-related osteoporosis with current pathological fracture, right shoulder, sequela

M80.012A Age-related osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture

M80.012D Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with routine healing

M80.012G Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with delayed healing

M80.012K Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion

M80.012P Age-related osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with malunion

M80.012S Age-related osteoporosis with current pathological fracture, left shoulder, sequela

M80.019A Age-related osteoporosis with current pathological fracture, unspecified shoulder, initial encounter for fracture

M80.019D Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with routine healing

M80.019G Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with delayed healing

M80.019K Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with nonunion

M80.019P Age-related osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with malunion

M80.019S Age-related osteoporosis with current pathological fracture, unspecified shoulder, sequela

M80.021A Age-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture

M80.021D Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with routine healing

M80.021G Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with delayed healing

M80.021K Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with nonunion

M80.021P Age-related osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion

M80.021S Age-related osteoporosis with current pathological fracture, right humerus, sequela

M80.022A Age-related osteoporosis with current pathological fracture, left humerus, initial encounter for fracture

M80.022D Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with routine healing

M80.022G Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with delayed healing

M80.022K Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with nonunion

M80.022P Age-related osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with malunion

M80.022S Age-related osteoporosis with current pathological fracture, left humerus, sequela

M80.029A Age-related osteoporosis with current pathological fracture, unspecified humerus, initial encounter for fracture

M80.029D Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with routine healing

M80.029G Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing

M80.029K Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with nonunion

M80.029P Age-related osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with malunion

M80.029S Age-related osteoporosis with current pathological fracture, unspecified humerus, sequela

M80.031A Age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture

M80.031D Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with routine healing

M80.031G Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with delayed healing

M80.031K Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with nonunion

M80.031P Age-related osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with malunion

M80.031S Age-related osteoporosis with current pathological fracture, right forearm, sequela

M80.032A Age-related osteoporosis with current pathological fracture, left forearm, initial encounter for fracture

M80.032D Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with routine healing

M80.032G Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with delayed healing

M80.032K Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with nonunion

M80.032P Age-related osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with malunion

M80.032S Age-related osteoporosis with current pathological fracture, left forearm, sequela

M80.039A Age-related osteoporosis with current pathological fracture, unspecified forearm, initial encounter for fracture

M80.039D Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with routine healing

M80.039G Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with delayed healing

M80.039K Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with nonunion

M80.039P Age-related osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with malunion

M80.039S Age-related osteoporosis with current pathological fracture, unspecified forearm, sequela

M80.041A Age-related osteoporosis with current pathological fracture, right hand, initial encounter for fracture

M80.041D Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with routine healing

M80.041G Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with delayed healing

M80.041K Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with nonunion

M80.041P Age-related osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with malunion

M80.041S Age-related osteoporosis with current pathological fracture, right hand, sequela

M80.042A Age-related osteoporosis with current pathological fracture, left hand, initial encounter for fracture

M80.042D Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with routine healing

M80.042G Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with delayed healing

M80.042K Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with nonunion

M80.042P Age-related osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with malunion

M80.042S Age-related osteoporosis with current pathological fracture, left hand, sequela

M80.049A Age-related osteoporosis with current pathological fracture, unspecified hand, initial encounter for fracture

M80.049D Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with routine healing

M80.049G Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with delayed healing

M80.049K Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with nonunion

M80.049P Age-related osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with malunion

M80.049S Age-related osteoporosis with current pathological fracture, unspecified hand, sequela

M80.051A Age-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture

M80.051D Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with routine healing

M80.051G Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing

M80.051K Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion

M80.051P Age-related osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion

M80.051S Age-related osteoporosis with current pathological fracture, right femur, sequela

M80.052A Age-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture

M80.052D Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with routine healing

M80.052G Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing

M80.052K Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion

M80.052P Age-related osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion

M80.052S Age-related osteoporosis with current pathological fracture, left femur, sequela

M80.059A Age-related osteoporosis with current pathological fracture, unspecified femur, initial encounter for fracture

M80.059D Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with routine healing

M80.059G Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with delayed healing

M80.059K Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with nonunion

M80.059P Age-related osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with malunion

M80.059S Age-related osteoporosis with current pathological fracture, unspecified femur, sequela

M80.061A Age-related osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture

M80.061D Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with routine healing

M80.061G Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with delayed healing

M80.061K Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion

M80.061P Age-related osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with malunion

M80.061S Age-related osteoporosis with current pathological fracture, right lower leg, sequela

M80.062A Age-related osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture

M80.062D Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with routine healing

M80.062G Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with delayed healing

M80.062K Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with nonunion

M80.062P Age-related osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with malunion

M80.062S Age-related osteoporosis with current pathological fracture, left lower leg, sequela

M80.069A Age-related osteoporosis with current pathological fracture, unspecified lower leg, initial encounter for fracture

M80.069D Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with routine healing

M80.069G Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with delayed healing

M80.069K Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with nonunion

M80.069P Age-related osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with malunion

M80.069S Age-related osteoporosis with current pathological fracture, unspecified lower leg, sequela

M80.071A Age-related osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture

M80.071D Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with routine healing

M80.071G Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with delayed healing

M80.071K Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with nonunion

M80.071P Age-related osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with malunion

M80.071S Age-related osteoporosis with current pathological fracture, right ankle and foot, sequela

M80.072A Age-related osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture

M80.072D Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with routine healing

M80.072G Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with delayed healing

M80.072K Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with nonunion

M80.072P Age-related osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with malunion

M80.072S Age-related osteoporosis with current pathological fracture, left ankle and foot, sequela

M80.079A Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture

M80.079D Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with routine healing

M80.079G Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with delayed healing

M80.079K Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with nonunion

M80.079P Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with malunion

M80.079S Age-related osteoporosis with current pathological fracture, unspecified ankle and foot, sequela

M80.08XA Age-related osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture

M80.08XD Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with routine healing

M80.08XG Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing

M80.08XK Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with nonunion

M80.08XP Age-related osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion

M80.08XS Age-related osteoporosis with current pathological fracture, vertebra(e), sequela

M80.80XA Other osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture

M80.80XD Other osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with routine healing

M80.80XG Other osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with delayed healing

M80.80XK Other osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with nonunion

M80.80XP Other osteoporosis with current pathological fracture, unspecified site, subsequent encounter for fracture with malunion

M80.80XS Other osteoporosis with current pathological fracture, unspecified site, sequela

M80.811A Other osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture

M80.811D Other osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with routine healing

M80.811G Other osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with delayed healing

M80.811K Other osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with nonunion

M80.811P Other osteoporosis with current pathological fracture, right shoulder, subsequent encounter for fracture with malunion

M80.811S Other osteoporosis with current pathological fracture, right shoulder, sequela

M80.812A Other osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture

M80.812D Other osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with routine healing

M80.812G Other osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with delayed healing

M80.812K Other osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with nonunion

M80.812P Other osteoporosis with current pathological fracture, left shoulder, subsequent encounter for fracture with malunion

M80.812S Other osteoporosis with current pathological fracture, left shoulder, sequela

M80.819A Other osteoporosis with current pathological fracture, unspecified shoulder, initial encounter for fracture

M80.819D Other osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with routine healing

M80.819G Other osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with delayed healing

M80.819K Other osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with nonunion

M80.819P Other osteoporosis with current pathological fracture, unspecified shoulder, subsequent encounter for fracture with malunion

M80.819S Other osteoporosis with current pathological fracture, unspecified shoulder, sequela

M80.821A Other osteoporosis with current pathological fracture, right humerus, initial encounter for fracture

M80.821D Other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with routine healing

M80.821G Other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with delayed healing

M80.821K Other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with nonunion

M80.821P Other osteoporosis with current pathological fracture, right humerus, subsequent encounter for fracture with malunion

M80.821S Other osteoporosis with current pathological fracture, right humerus, sequela

M80.822A Other osteoporosis with current pathological fracture, left humerus, initial encounter for fracture

M80.822D Other osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with routine healing

M80.822G Other osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with delayed healing

M80.822K Other osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with nonunion

M80.822P Other osteoporosis with current pathological fracture, left humerus, subsequent encounter for fracture with malunion

M80.822S Other osteoporosis with current pathological fracture, left humerus, sequela

M80.829A Other osteoporosis with current pathological fracture, unspecified humerus, initial encounter for fracture

M80.829D Other osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with routine healing

M80.829G Other osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with delayed healing

M80.829K Other osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with nonunion

M80.829P Other osteoporosis with current pathological fracture, unspecified humerus, subsequent encounter for fracture with malunion

M80.829S Other osteoporosis with current pathological fracture, unspecified humerus, sequela

M80.831A Other osteoporosis with current pathological fracture, right forearm, initial encounter for fracture

M80.831D Other osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with routine healing

M80.831G Other osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with delayed healing

M80.831K Other osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with nonunion

M80.831P Other osteoporosis with current pathological fracture, right forearm, subsequent encounter for fracture with malunion

M80.831S Other osteoporosis with current pathological fracture, right forearm, sequela

M80.832A Other osteoporosis with current pathological fracture, left forearm, initial encounter for fracture

M80.832D Other osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with routine healing

M80.832G Other osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with delayed healing

M80.832K Other osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with nonunion

M80.832P Other osteoporosis with current pathological fracture, left forearm, subsequent encounter for fracture with malunion

M80.832S Other osteoporosis with current pathological fracture, left forearm, sequela

M80.839A Other osteoporosis with current pathological fracture, unspecified forearm, initial encounter for fracture

M80.839D Other osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with routine healing

M80.839G Other osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with delayed healing

M80.839K Other osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with nonunion

M80.839P Other osteoporosis with current pathological fracture, unspecified forearm, subsequent encounter for fracture with malunion

M80.839S Other osteoporosis with current pathological fracture, unspecified forearm, sequela

M80.841A Other osteoporosis with current pathological fracture, right hand, initial encounter for fracture

M80.841D Other osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with routine healing

M80.841G Other osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with delayed healing

M80.841K Other osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with nonunion

M80.841P Other osteoporosis with current pathological fracture, right hand, subsequent encounter for fracture with malunion

M80.841S Other osteoporosis with current pathological fracture, right hand, sequela

M80.842A Other osteoporosis with current pathological fracture, left hand, initial encounter for fracture

M80.842D Other osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with routine healing

M80.842G Other osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with delayed healing

M80.842K Other osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with nonunion

M80.842P Other osteoporosis with current pathological fracture, left hand, subsequent encounter for fracture with malunion

M80.842S Other osteoporosis with current pathological fracture, left hand, sequela

M80.849A Other osteoporosis with current pathological fracture, unspecified hand, initial encounter for fracture

M80.849D Other osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with routine healing

M80.849G Other osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with delayed healing

M80.849K Other osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with nonunion

M80.849P Other osteoporosis with current pathological fracture, unspecified hand, subsequent encounter for fracture with malunion

M80.849S Other osteoporosis with current pathological fracture, unspecified hand, sequela

M80.851A Other osteoporosis with current pathological fracture, right femur, initial encounter for fracture

M80.851D Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with routine healing

M80.851G Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with delayed healing

M80.851K Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with nonunion

M80.851P Other osteoporosis with current pathological fracture, right femur, subsequent encounter for fracture with malunion

M80.851S Other osteoporosis with current pathological fracture, right femur, sequela

M80.852A Other osteoporosis with current pathological fracture, left femur, initial encounter for fracture

M80.852D Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with routine healing

M80.852G Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with delayed healing

M80.852K Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with nonunion

M80.852P Other osteoporosis with current pathological fracture, left femur, subsequent encounter for fracture with malunion

M80.852S Other osteoporosis with current pathological fracture, left femur, sequela

M80.859A Other osteoporosis with current pathological fracture, unspecified femur, initial encounter for fracture

M80.859D Other osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with routine healing

M80.859G Other osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with delayed healing

M80.859K Other osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with nonunion

M80.859P Other osteoporosis with current pathological fracture, unspecified femur, subsequent encounter for fracture with malunion

M80.859S Other osteoporosis with current pathological fracture, unspecified femur, sequela

M80.861A Other osteoporosis with current pathological fracture, right lower leg, initial encounter for fracture

M80.861D Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with routine healing

M80.861G Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with delayed healing

M80.861K Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with nonunion

M80.861P Other osteoporosis with current pathological fracture, right lower leg, subsequent encounter for fracture with malunion

M80.861S Other osteoporosis with current pathological fracture, right lower leg, sequela

M80.862A Other osteoporosis with current pathological fracture, left lower leg, initial encounter for fracture

M80.862D Other osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with routine healing

M80.862G Other osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with delayed healing

M80.862K Other osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with nonunion

M80.862P Other osteoporosis with current pathological fracture, left lower leg, subsequent encounter for fracture with malunion

M80.862S Other osteoporosis with current pathological fracture, left lower leg, sequela

M80.869A Other osteoporosis with current pathological fracture, unspecified lower leg, initial encounter for fracture

M80.869D Other osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with routine healing

M80.869G Other osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with delayed healing

M80.869K Other osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with nonunion

M80.869P Other osteoporosis with current pathological fracture, unspecified lower leg, subsequent encounter for fracture with malunion

M80.869S Other osteoporosis with current pathological fracture, unspecified lower leg, sequela

M80.871A Other osteoporosis with current pathological fracture, right ankle and foot, initial encounter for fracture

M80.871D Other osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with routine healing

M80.871G Other osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with delayed healing

M80.871K Other osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with nonunion

M80.871P Other osteoporosis with current pathological fracture, right ankle and foot, subsequent encounter for fracture with malunion

M80.871S Other osteoporosis with current pathological fracture, right ankle and foot, sequela

M80.872A Other osteoporosis with current pathological fracture, left ankle and foot, initial encounter for fracture

M80.872D Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with routine healing

M80.872G Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with delayed healing

M80.872K Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with nonunion

M80.872P Other osteoporosis with current pathological fracture, left ankle and foot, subsequent encounter for fracture with malunion

M80.872S Other osteoporosis with current pathological fracture, left ankle and foot, sequela

M80.879A Other osteoporosis with current pathological fracture, unspecified ankle and foot, initial encounter for fracture

M80.879D Other osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with routine healing

M80.879G Other osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with delayed healing

M80.879K Other osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with nonunion

M80.879P Other osteoporosis with current pathological fracture, unspecified ankle and foot, subsequent encounter for fracture with malunion

M80.879S Other osteoporosis with current pathological fracture, unspecified ankle and foot, sequela

M80.88XA Other osteoporosis with current pathological fracture, vertebra(e), initial encounter for fracture

M80.88XD Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with routine healing

M80.88XG Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with delayed healing

M80.88XK Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with nonunion

M80.88XP Other osteoporosis with current pathological fracture, vertebra(e), subsequent encounter for fracture with malunion

M80.88XS Other osteoporosis with current pathological fracture, vertebra(e), sequela

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

M85.9 Disorder of bone density and structure, unspecified

M89.9 Disorder of bone, unspecified

M94.9 Disorder of cartilage, unspecified

N18.3 Chronic kidney disease, stage 3 (moderate)

N18.4 Chronic kidney disease, stage 4 (severe)

N18.5 Chronic kidney disease, stage 5

N18.6 End stage renal disease

Q78.0 Osteogenesis imperfecta

Q78.2 Osteopetrosis

Z79.3 Long term (current) use of hormonal contraceptives

Z79.51 Long term (current) use of inhaled steroids

Z79.52 Long term (current) use of systemic steroids

Z79.891 Long term (current) use of opiate analgesic

Z79.899 Other long term (current) drug therapy

MEDICALLY NECESSARY FOR 82652

A15.0 Tuberculosis of lung

A15.4 Tuberculosis of intrathoracic lymph nodes

A15.5 Tuberculosis of larynx, trachea and bronchus

A15.6 Tuberculous pleurisy

A15.7 Primary respiratory tuberculosis

A15.8 Other respiratory tuberculosis

A15.9 Respiratory tuberculosis unspecified

A17.0 Tuberculous meningitis

A17.1 Meningeal tuberculoma

A17.81 Tuberculoma of brain and spinal cord

A17.82 Tuberculous meningoencephalitis

A17.83 Tuberculous neuritis

A17.89 Other tuberculosis of nervous system

A17.9 Tuberculosis of nervous system, unspecified

A18.01 Tuberculosis of spine

A18.02 Tuberculous arthritis of other joints

A18.03 Tuberculosis of other bones

A18.09 Other musculoskeletal tuberculosis

A18.10 Tuberculosis of genitourinary system, unspecified

A18.11 Tuberculosis of kidney and ureter

A18.12 Tuberculosis of bladder

A18.13 Tuberculosis of other urinary organs

A18.14 Tuberculosis of prostate

A18.15 Tuberculosis of other male genital organs

A18.16 Tuberculosis of cervix

A18.17 Tuberculous female pelvic inflammatory disease

A18.18 Tuberculosis of other female genital organs

A18.2 Tuberculous peripheral lymphadenopathy

A18.31 Tuberculous peritonitis

A18.32 Tuberculous enteritis

A18.39 Retroperitoneal tuberculosis

A18.4 Tuberculosis of skin and subcutaneous tissue

A18.50 Tuberculosis of eye, unspecified

A18.51 Tuberculous episcleritis

A18.52 Tuberculous keratitis

A18.53 Tuberculous chorioretinitis

A18.54 Tuberculous iridocyclitis

A18.59 Other tuberculosis of eye

A18.6 Tuberculosis of (inner) (middle) ear

A18.7 Tuberculosis of adrenal glands

A18.81 Tuberculosis of thyroid gland

A18.82 Tuberculosis of other endocrine glands

A18.83 Tuberculosis of digestive tract organs, not elsewhere classified

A18.84 Tuberculosis of heart

A18.85 Tuberculosis of spleen

A18.89 Tuberculosis of other sites

A19.0 Acute miliary tuberculosis of a single specified site

A19.1 Acute miliary tuberculosis of multiple sites

A19.2 Acute miliary tuberculosis, unspecified

A19.8 Other miliary tuberculosis

A19.9 Miliary tuberculosis, unspecified

D71 Functional disorders of polymorphonuclear neutrophils

D86.0 Sarcoidosis of lung

D86.1 Sarcoidosis of lymph nodes

D86.2 Sarcoidosis of lung with sarcoidosis of lymph nodes

D86.3 Sarcoidosis of skin

D86.81 Sarcoid meningitis

D86.82 Multiple cranial nerve palsies in sarcoidosis

D86.83 Sarcoid iridocyclitis

D86.84 Sarcoid pyelonephritis

D86.85 Sarcoid myocarditis

D86.86 Sarcoid arthropathy

D86.87 Sarcoid myositis

D86.89 Sarcoidosis of other sites

D86.9 Sarcoidosis, unspecified

E55.0 Rickets, active

E67.2 Megavitamin-B6 syndrome

E67.3 Hypervitaminosis D

E67.8 Other specified hyperalimentation

E68 Sequelae of hyperalimentation

N18.3 Chronic kidney disease, stage 3 (moderate)

N18.4 Chronic kidney disease, stage 4 (severe)

N18.5 Chronic kidney disease, stage 5

N18.6 End stage renal disease

Q78.0 Osteogenesis imperfecta

Q78.2 Osteopetrosis




HCPCS Level II Code Number(s)

N/A


Revenue Code Number(s)

N/A

Coding and Billing Requirements






Policy History

Revisions from MA06.031c
11/21/2018This policy has been reissued in accordance with the Company's annual review process.
10/01/2018Effective 10/01/2018, the following diagnosis code has been deleted from this policy due to coding updates: M79.1

Effective 10/01/2018, the following diagnosis codes have been added to this policy due to coding updates: M79.10, M79.11, M79.12, M79.18

Revisions from MA06.031b:
04/01/2018Effective 04/01/2018, the following CPT codes have been added to this policy due to coding updates:

0038U

Revision from MA06.031a
10/01/2017This version of the policy is effective as of 10/01/2017.

Narratives of the following ICD-10 codes have been revised in this policy:

M33.00
M33.01
M33.02
M33.09
M33.10
M33.11
M33.12
M33.19


The following ICD-10 codes have been added to this policy, and are eligible only when reported with CPT code 82306:

M33.03
M33.13
M33.93

Revisions from MA06.031
06/21/2017This policy has been reissued in accordance with the Company's annual review process.
08/01/2016The following new policy has been developed to communicate the Company’s coverage criteria for Vitamin D Assay Testing. New policy number MA06.31 was issued as a result of this development.





Version Effective Date: 10/01/2018
Version Issued Date: 11/09/2018
Version Reissued Date: 11/28/2018