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MA06.032a
A
MA06.032a
ICD 10 CODES FOR MEDICALLY NECESSARY COBALAMIN (VITAMIN B12), FOLIC ACID, AND/OR HOMOCYSTEINE TESTING (CPT CODES 82607, 82746, AND 83090)
Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing


COBALAMIN (VITAMIN B12), FOLIC ACID, AND/OR HOMOCYSTEINE TESTING (CPT CODES 82607, 82746, AND 83090) ARE MEDICALLY NECESSARY WHEN REPORTED WITH THE FOLLOWING DIAGNOSIS CODES

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
D81.818            Other biotin-dependent carboxylase deficiency
D81.819            Biotin-dependent carboxylase deficiency, unspecified
E41                  Nutritional marasmus
E43                  Unspecified severe 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, unspecified severity, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety​
F03.911            Unspecified dementia, unspecified severity, with agitation
F03.918            Unspecified dementia, unspecified severity, with other behavioral disturbance
F03.92              Unspecified dementia, unspecified severity, with psychotic disturbance
F03.93              Unspecified dementia, unspecified severity, with mood disturbance
F03.94              Unspecified dementia, unspecified severity, with anxiety
F03.A0             Unspecified dementia, mild, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.A11            Unspecified dementia, mild, with agitation
F03.A18            Unspecified dementia, mild, with other behavioral disturbance
F03.A2             Unspecified dementia, mild, with psychotic disturbance
F03.A3             Unspecified dementia, mild, with mood disturbance
F03.A4             Unspecified dementia, mild, with anxiety
F03.B0             Unspecified dementia, moderate, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.B11            Unspecified dementia, moderate, with agitation
F03.B18            Unspecified dementia, moderate, with other behavioral disturbance
F03.B2             Unspecified dementia, moderate, with psychotic disturbance
F03.B3             Unspecified dementia, moderate, with mood disturbance
F03.B4             Unspecified dementia, moderate, with anxiety
F03.C0             Unspecified dementia, severe, without behavioral disturbance, psychotic disturbance, mood disturbance, and anxiety
F03.C11           Unspecified dementia, severe, with agitation
F03.C18           Unspecified dementia, severe, with other behavioral disturbance
F03.C2             Unspecified dementia, severe, with psychotic disturbance
F03.C3             Unspecified dementia, severe, with mood disturbance
F03.C4             Unspecified dementia, severe, with anxiety
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
K90.0               Celiac disease
K90.1               Tropical sprue
K90.2               Blind loop syndrome, not elsewhere classified
K90.3               Pancreatic steatorrhea
K90.49              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
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
R41.82             Altered mental status, unspecified
R41.9               Unspecified symptoms and signs involving cognitive functions and awareness
R45.84             Anhedonia
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
Z86.39              Personal history of other endocrine, nutritional and metabolic disease
Z98.0                Intestinal bypass and anastomosis status
Z99.2                Dependence on renal dialysis​

01/01/2024
01/01/2024
07/10/2024
Medical Policy Bulletin
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