What are the CPT (Current Procedural Terminology) codes for vitamin D laboratory tests?

CPT Codes for Vitamin D Laboratory Tests

The primary CPT codes for vitamin D laboratory testing are 82306 for vitamin D 25-hydroxy testing and 82652 for 1,25-dihydroxyvitamin D testing.

Types of Vitamin D Tests and Their CPT Codes

Primary Vitamin D Tests

• 82306: Vitamin D; 25 hydroxy (calcidiol), includes fractions if performed

  • This is the most common test used to assess vitamin D status
  • Measures both 25(OH)D2 and 25(OH)D3, which are the major circulating forms of vitamin D

• 82652: Vitamin D; 1,25 dihydroxy (calcitriol)

  • This test measures the active hormonal form of vitamin D
  • Not typically used for routine vitamin D status assessment

Testing Methodology Considerations

The testing methodology for vitamin D has important implications:

• LC-MS/MS (liquid chromatography-tandem mass spectrometry) is considered the gold standard method for 25(OH)D measurement 1
• This method can separately quantify 25(OH)D2 and 25(OH)D3 2
• Testing variability between methods and laboratories can be significant, with classification of samples as "deficient" or "nondeficient" varying by 4% to 32% depending on which assay is used 1

Clinical Context for Vitamin D Testing

When ordering vitamin D tests, consider:

1. Test Selection: 25(OH)D (CPT 82306) is the appropriate test for assessing vitamin D status in most clinical scenarios 1

2. Sample Collection:

   • Serum is the sample of choice
   • Avoid gel tubes until more data are available 1
   • Both serum and plasma (heparin or EDTA) can be used with comparable results when using LC-MS/MS methods 2

3. Reference Range Considerations:

   • Most experts recommend a target 25(OH)D range of 30-100 ng/mL 1
   • The recommended daily oral intakes of vitamin D vary between 600 and 800 IU in adults 1

Important Caveats

• There is significant variability between different vitamin D testing methods and laboratories 1
• The Centers for Disease Control and Prevention offers the Vitamin D Standardization Certification Program to help laboratories maintain quality and comparability of measurement results 1
• When interpreting results, be aware that 25(OH)D may act as a negative acute-phase reactant, with levels potentially decreasing in response to inflammation 1
• Racial differences in vitamin D binding protein may affect interpretation of total 25(OH)D levels, particularly in African Americans 1

Remember that while CPT code 82306 (25-hydroxy vitamin D) is the standard test for assessing vitamin D status, code 82652 (1,25-dihydroxy vitamin D) should be reserved for specific clinical scenarios where assessment of the active hormonal form is necessary.