Measurement of Serum 1,25-dihydroxyvitamin D (CPT 82652)
Defines Fidelis Care's payment and coverage stance for measurement of serum 1,25(OH)2D (CPT 82652) for monitoring specific diagnoses and states that routine screening of average-risk asymptomatic individuals is not covered. Applies to all Fidelis Care products except Medicare.
No material clinical or coverage changes in this revision.
Coverage Criteria for Measurement of Serum 1,25(OH)2D
Coverage criteria for serum 1,25-dihydroxyvitamin D
Covered when ALL of the following are met:
ALL of the following
One of the following covered diagnoses
- C81.00-C81.99 — Hodgkin lymphoma
- A15.0-A15.9 — Respiratory tuberculosis
- C82.00-C82.99 — Follicular lymphoma
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