Pathology/Lab Avg. $40

CPT 82306: Vitamin D, 25-Hydroxy

Vitamin D; 25 hydroxy, includes fraction(s), if performed. The standard test for assessing vitamin D status.

Why CPT 82306 Claims Get Denied

Claims billed under CPT 82306 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.

Not medically necessary for screening without risk factors

Frequency limit exceeded (more than once per year)

Insufficient diagnosis to support testing

Some payers consider routine screening experimental

Billing Tips for CPT 82306

Many payers limit vitamin D testing to patients with risk factors or documented deficiency. Use a specific diagnosis code (E55.9 for vitamin D deficiency, M81.0 for osteoporosis). Medicare Local Coverage Determinations vary — check your MAC's LCD for covered indications.

Documentation Requirements

To support a clean claim for CPT 82306, your clinical documentation should include:

Clinical indication for testing (risk factors, symptoms, monitoring)

Provider order

Results with interpretation

Treatment plan for deficiency if applicable

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