What is the ICD-10 (International Classification of Diseases, 10th Revision) code for checking vitamin D levels?

ICD-10 Codes for Vitamin D Level Testing

The appropriate ICD-10 code for checking vitamin D levels is E55.9 (Vitamin D deficiency, unspecified). This code should be used when ordering vitamin D testing in patients with suspected deficiency without manifestations of rickets or osteomalacia 1.

Primary Diagnostic Codes for Vitamin D Testing

When ordering vitamin D level testing, consider the following ICD-10 codes based on clinical presentation:

• E55.9 - Vitamin D deficiency, unspecified (primary code for routine vitamin D testing)
• E55.0 - Rickets, active (for vitamin D testing in patients with active rickets)
• M83.0-M83.9 - Adult osteomalacia (for vitamin D testing in patients with osteomalacia)

Clinical Scenarios Supporting Vitamin D Testing

The U.S. Preventive Services Task Force does not recommend routine screening for vitamin D deficiency in the general population 1. However, testing is appropriate in specific clinical scenarios:

• Patients with risk factors for vitamin D deficiency:

  • Limited sun exposure (winter season, high latitude, physical sun avoidance)
  • Darker skin pigmentation
  • Obesity (BMI > 30)
  • Advanced age (especially those >65 years)
  • Institutionalized individuals
  • Malabsorption syndromes
  • Chronic liver disease
  • Chronic kidney disease

• Patients with conditions potentially related to vitamin D status:

  • Osteoporosis or history of fragility fractures
  • Chronic liver disease 1
  • Hypocalcemia
  • Secondary hyperparathyroidism

Documentation Requirements

For proper reimbursement when using E55.9 or other vitamin D-related ICD-10 codes:

1. Document specific clinical indications for testing vitamin D levels
2. Note risk factors for vitamin D deficiency in the medical record
3. Document any signs or symptoms that might be related to vitamin D deficiency
4. Include any relevant medical conditions that increase risk for or are affected by vitamin D status

Important Considerations

• The optimal target range for vitamin D levels is 30-40 ng/mL (75-100 nmol/L) 2
• There is significant variability between vitamin D assay methods, with classification of samples as "deficient" or "nondeficient" varying by 4% to 32% depending on which assay is used 1
• Vitamin D testing rates have been increasing significantly, with a more than tripling of outpatient visits associated with vitamin D deficiency between 2008 and 2010 1

Follow-up Testing

If vitamin D deficiency is identified and treatment initiated:

• Check vitamin D levels in 3 months to ensure target level has been reached
• Monitor annually once stable levels are achieved 2
• Consider using the same ICD-10 code (E55.9) for follow-up testing to monitor treatment response

Remember that while E55.9 is the most commonly used code for vitamin D testing, the specific clinical context may warrant using a different ICD-10 code to better reflect the medical necessity for the test.