Medicare and Vitamin D Tests

Options
cinnamonsmile
cinnamonsmile Member Posts: 1,187 Member
in Breast Cancer #1

I had a Vitamin D test last year and Medicare refused to pay for it. I was told by the billing and coding department that Medicare never pays for it. I called Medicare and was told, yes, Medicare can pay for it. I asked about how the clinic should bill it and code and Medicare would not tell me.

Because of the bad service I received and being lied to, the clinic footed the over $200 bill for the Vitamin D level test.

I am due for another test and can't afford to pay that out of pocket.

Does anyone know how to bill and code Vitamin D level tests so Medicare pays for it?

Thanks!

Comments

  • GlowMore
    GlowMore Member Posts: 789 Member
    #2
    Options
    Medicare**

    Cinnamon...........my Oncologist submits my bills and so did my Radation Oncologist.....they are the ones who have to know the codes....not us.     

    Not sure what this has to do with Breast Cancer though.

  • cinnamonsmile
    cinnamonsmile Member Posts: 1,187 Member
    #3
    Options
    GlowMore said:

    Medicare**

    Cinnamon...........my Oncologist submits my bills and so did my Radation Oncologist.....they are the ones who have to know the codes....not us.     

    Not sure what this has to do with Breast Cancer though.

    Off Topic Posts

    Every so often we post about things that are "off topic." Sometimes it may be family things, events that have happened, vacations,etc. So every thing on here is not exactly related to breast cancer.

    There are a lot of great women on here with a lot of experience and knowldege who have experiences that help others, whether it be direct cancer issues or not, who help others.

    And sometimes, we do learn codes as patients. Last year I was seeing a dietitician and the coding department was coding the sessions wrong so I got to learn the codes so when Medicare rejected it, I could call them and tell them the wrong code was used. Our billing departmentment sends out the codes on the itemized billing statement.

  • New Flower
    New Flower Member Posts: 4,294
    #4
    Options
    cinnamonsmile said:

    Off Topic Posts

    Every so often we post about things that are "off topic." Sometimes it may be family things, events that have happened, vacations,etc. So every thing on here is not exactly related to breast cancer.

    There are a lot of great women on here with a lot of experience and knowldege who have experiences that help others, whether it be direct cancer issues or not, who help others.

    And sometimes, we do learn codes as patients. Last year I was seeing a dietitician and the coding department was coding the sessions wrong so I got to learn the codes so when Medicare rejected it, I could call them and tell them the wrong code was used. Our billing departmentment sends out the codes on the itemized billing statement.

    Can you try

    Please ask your doctor's office to obtain insurance autorization before you got the test. Most likely coverage depends on primary diagnosis. While It is not easy, please to work with both doctor's office and Medicare. Ask your doctor's office where did they send your labs for Vit D. You might have to go to Quest or LabCorp to get less expensive labs. if you call them (Quest, LabCorp or other huge labs provider), they will tell you if it will be covered by Medicare and how much would it cost.  

    Let us know results.

    Hugs

  • Puffin2014
    Puffin2014 Member Posts: 531 Member
    #5
    Options
    cinnamonsmile said:

    Off Topic Posts

    Every so often we post about things that are "off topic." Sometimes it may be family things, events that have happened, vacations,etc. So every thing on here is not exactly related to breast cancer.

    There are a lot of great women on here with a lot of experience and knowldege who have experiences that help others, whether it be direct cancer issues or not, who help others.

    And sometimes, we do learn codes as patients. Last year I was seeing a dietitician and the coding department was coding the sessions wrong so I got to learn the codes so when Medicare rejected it, I could call them and tell them the wrong code was used. Our billing departmentment sends out the codes on the itemized billing statement.

    coding

    Whoa works in coding, I'll check and see if she knows anything about Vit D level coding. Many of us with breast cancer are having Vit D levels drawn (I'm having my first one drawn Tuesday) and are interested in this topic.

  • Pixie Dust
    Pixie Dust Member Posts: 424 Member
    #6
    Options
    Vitamin D coding

    Since Puffin is going to check with Whoa she will probably know. If not I can call my doc office and ask the coding person for you what it is, or Puffin when you go to have your testing done ask then. We are all sisters on here trying to help one another. Glow most people with Breast Cancer are tested for this and has to take Vitamin D.   Hugs,   Pixie

  • jerseygirl231
    jerseygirl231 Member Posts: 178
    #7
    Options
    cinnamonsmile said:

    Off Topic Posts

    Every so often we post about things that are "off topic." Sometimes it may be family things, events that have happened, vacations,etc. So every thing on here is not exactly related to breast cancer.

    There are a lot of great women on here with a lot of experience and knowldege who have experiences that help others, whether it be direct cancer issues or not, who help others.

    And sometimes, we do learn codes as patients. Last year I was seeing a dietitician and the coding department was coding the sessions wrong so I got to learn the codes so when Medicare rejected it, I could call them and tell them the wrong code was used. Our billing departmentment sends out the codes on the itemized billing statement.

    sent you the code

    unless the change it. i took med code and billing I sent you the CPT code

  • cinnamonsmile
    cinnamonsmile Member Posts: 1,187 Member
    #8
    Options
    Pixie Dust said:

    Vitamin D coding

    Since Puffin is going to check with Whoa she will probably know. If not I can call my doc office and ask the coding person for you what it is, or Puffin when you go to have your testing done ask then. We are all sisters on here trying to help one another. Glow most people with Breast Cancer are tested for this and has to take Vitamin D.   Hugs,   Pixie

    Pixie, I called my billing

    Pixie, I called my billing department (they wouldn't put me through to coding) and the clinic representative lied to me and said Medicare NEVER pays it. I called Medicare and was told by the Medicare agent that the clinic rep lied to me. So the clinic is refusing to help me figure out how to get Medicare to pay for it.

  • camul
    camul Member Posts: 2,537
    #9
    Options
    My endocrinologist just added

    My endocrinologist just added it on to my blood panel for thyroid (I dont have a thyroid). once a year, and my onco che ks it a few times a yer. I have bone mets. Loww vit D is related to. cancer. Dont know what they code it thou, so I am not much help there. But a few months b4 mets dx, my endo figured my bc was back. based on low vit D, high cortizol, and thyroid issues. Didnt show in blood/pet scans til Sept. There was an article in 2011 or so relating low vit d and bc cancer.>

  • cinnamonsmile
    cinnamonsmile Member Posts: 1,187 Member
    #10
    Options
    I've been googling online and

    I've been googling online and it is not just a matter of coding. It appears there is a SMALL listing of conditions one must have to have a Medicare approved Vitamin D test.

    So far a cancer diagnoses does not qualify in some states!

  • Puffin2014
    Puffin2014 Member Posts: 531 Member
    #11
    Options
    cinnamonsmile said:

    I've been googling online and

    I've been googling online and it is not just a matter of coding. It appears there is a SMALL listing of conditions one must have to have a Medicare approved Vitamin D test.

    So far a cancer diagnoses does not qualify in some states!

    how about osteopenia and osteoporosis?

    Are osteopenia and osteoporosis on the short list of diagnoses?

Discussion Boards