ROCHESTER, N.Y. According to a report released today by Excellus BlueCross BlueShield, nearly nine out of ten upstate New Yorkers have no medical need to have their vitamin D levels evaluated, but health care providers and consumers continue to seek the test frequently.
Last year, 641,000 people in upstate New York had their vitamin D levels checked, with around 42% of them doing so without a medical reason. Only patients with particular medical diseases, such as osteoporosis, kidney and liver illness, malabsorption syndromes, bone abnormalities, and certain endocrine disorders, are usually tested. Vitamin D testing is also recommended for older persons, pregnant or lactating women, and some pregnant or lactating women.
“Even if there is a medical need to test for vitamin D insufficiency, it’s reasonable to question whether the test is necessary,” said Matthew Bartels, M.D., Excellus BCBS medical director for health care improvement. “If your doctor suspects a deficiency in vitamin D, taking an over-the-counter pill or increasing your vitamin D intake through your food may be enough.”
Widespread testing has been linked to potentially needless supplement therapies, retesting, and higher medical costs. A vitamin D deficiency test normally costs $50 and is covered by health insurance. According to an Excellus BCBS infographic titled “Vitamin D Tests,” an estimated $33 million was spent on vitamin D testing in upstate New York in 2014. Depending on the patient’s level of health insurance coverage, high-dose, prescription-strength vitamin D supplements may have an out-of-pocket cost.
Vitamin D is required for the proper functioning of our bodies. It aids in the absorption of calcium, which helps to maintain the health and strength of our bones and muscles, including the heart. “Most individuals receive adequate vitamin D from what they eat and how much time they spend in the sun,” Bartels said.
“Because previous studies have connected vitamin D insufficiency to a variety of illnesses, including heart disease and cancer,” said Bartels, “patients and physicians began seeking more tests.” “A more recent critical examination of these reports has revealed serious problems, prompting many in the medical profession to question the need for widespread testing.”
The present medical evidence is insufficient to determine the balance of benefits and hazards of screening for vitamin D deficiency in asymptomatic people, according to the US Preventive Services Task Force.
“Many people have low levels of vitamin D, but few have critically low levels,” according to the American Society of Clinical Pathology, which contributed to Choosing Wisely. A vitamin D test isn’t necessary for the majority of people. We only need to make a few little adjustments to ensure that we obtain enough vitamin D.”
Choosing Wisely is a foundation initiative of the American Board of Internal Medicine (ABIM) that includes over 300 care recommendations submitted by physician-led medical specialty societies to improve the quality of care and encourage conversations between physicians and patients about services that may be unnecessary and may cause harm.
According to Bartels, daily vitamin D intake through food and/or supplements should be 600 international units for people under the age of 70 and 800 international units for those over 70. “Taking a multivitamin or vitamin D supplement may not hurt to guarantee that you truly consume the necessary quantity,” he said.
The Excellus BCBS infographic cites cod liver oil, salmon, and tuna as foods high in vitamin D, in addition to multivitamins and vitamin D supplements. Vitamin D is supplemented in other, more widely consumed foods such as milk, cereal, and orange juice.
Getting five to 30 minutes of sun twice a week during the spring, summer, and fall can also provide us with all of the vitamin D we require throughout the year. Sun exposure isn’t recommended as a means to improve vitamin D levels since it raises the risk of skin cancer, according to the US Preventive Services Task Force.
“The reality is that only about one out of every ten people in upstate New York has a medical need to be checked,” Bartels said, adding that determining what a normal vitamin D level is challenging. Individuals with darker skin pigmentation, as well as those with a BMI that puts them in the obese category, can have low vitamin D levels. It’s uncertain whether low vitamin D levels are linked to negative health outcomes.
“There is insufficient medical evidence for any benefits of frequent vitamin D insufficiency testing in healthy people and children,” Bartels found. “Excellus BCBS’ purpose in evaluating the data and creating an infographic on the topic is to encourage patients and their doctors to have educated dialogues.”
Is vitamin D supplement covered by insurance?
Insurance companies will not reimburse you for over-the-counter purchases, but if you have a prescription, they may cover your vitamins. To cover prescription vitamins, most insurance companies will demand a pre-approval. If your doctor has prescribed the vitamin to treat a symptom or condition, this shouldn’t be an issue. They might ask your doctor to fill out a questionnaire, and they might only pay for it if you have a qualifying diagnosis. If feasible, do some research before your appointment to find out for prescription vitamin discounts and coupons so you can discuss them with your doctor. You may save even more money on your prescriptions by taking advantage of discounts.
Is vitamin D covered as preventive?
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Why is vitamin D not covered by Medicare?
If your doctor orders them, Medicare Part B and Medicare Advantage plans cover a wide range of clinical laboratory procedures, including blood testing. Vitamin D testing may be part of this, especially for people who are at a higher risk of deficiency.
Because a vitamin D test isn’t usually included in normal blood work, your doctor may need to demonstrate that it’s medically required before it’s covered. Supporting paperwork, such as verification of a medical condition known to cause vitamin D insufficiency or a detailed list of symptoms that could indicate a deficit, may be required.
Testing for vitamin D must be done in a Medicare-certified laboratory if the screening is approved. As long as the beneficiary has satisfied their appropriate deductible, original Medicare normally pays 20% of the cost. Depending on the plan and carrier, Medicare Advantage Plans may provide additional coverage.
If a chronic deficiency is detected, Medicare may pay for additional blood tests to keep track of the problem. Medicare may approve extra screenings to aid in the diagnosis if your doctor feels an underlying ailment is causing the deficiency. In some cases, yearly limits may apply.
What diagnosis code will cover vitamin D?
For 82306: Coders should use ICD-10 E55. 9 UNSPECIFIED VITAMIN D Insufficiency if more than one LCD-listed condition contributes to Vitamin D deficiency in a specific patient and/or is alleviated by Vitamin D therapy.
How much vitamin D should I take?
Healthy individuals should take 2,000 IU of vitamin D per day, with more if they get little or no sun exposure, according to the Vitamin D Council. It’s been proven that persons with a lot of body fat require more vitamin D than those who are slim.
How do you know you are vitamin D deficiency?
Muscle weakness, discomfort, weariness, and depression are all signs of vitamin D deficiency. To get adequate D, eat particular foods, take supplements, and get plenty of sun.
What’s the average vitamin D level?
Vitamin D levels in the normal range are measured in nanograms per milliliter (ng/mL). Many experts suggest a range of 20 to 40 ng/mL. Others advocate a concentration of 30 to 50 ng/mL.
The examples above are typical metrics for these tests’ outcomes. The normal value ranges may differ slightly between laboratories. Some laboratories test different samples or use different metrics. Consult your doctor about the implications of your individual test findings and whether vitamin D pills are necessary.
- 25 hydroxy vitamin D3 (cholecalciferol) is vitamin D produced by your body or absorbed from an animal source (fatty fish or liver) or a cholecalciferol supplement.
- The vitamin D you’ve absorbed from foods supplemented with plant vitamin D or from an ergocalciferol supplement is 25 hydroxy vitamin D2 (ergocalciferol).
- The two hormones (ergocalciferol and cholecalciferol) function in the body in a similar way. The total 25-hydroxyvitamin D level in your blood is the most relevant figure.
How can I check my vitamin D levels at home?
A vitamin D test determines how much vitamin D is present in your blood. These tests can determine whether your body has too much or too little vitamin D.
Both the vitamin D you eat and the vitamin D you get from the sun start out as an inactive form. The liver and kidneys then convert 25-hydroxyvitamin D (25-OH D) to 1,25-dihydroxy vitamin D, which is physiologically active.
The total level of 25-OH D in your blood is measured in most vitamin D tests. Because 25-OH D has a longer half-life than 1,25-dihydroxy vitamin D, this is the case.
How do vitamin D tests work?
To evaluate 25-OH D levels, vitamin D assays require a blood sample. A phlebotomist is a skilled technician who draws blood from a vein in your arm in a doctor’s office or a lab. Pricking and squeezing a finger to acquire a tiny blood sample is customary for at-home tests.
Because 25-OH D lasts longer in the bloodstream (about 14 days), it’s easier to test, and it’s also easier to identify variations in 25-OH D levels that are linked to vitamin D deficiency.
The half-life of 1,25-dihydroxy vitamin D, on the other hand, is only a few hours. Its levels may not decrease or fluctuate in a discernible way with vitamin D deficiency until the deficiency is severe.
Why do doctors check vitamin D levels?
A vitamin D test is used to detect or track bone problems. It’s also used to monitor vitamin D levels in those who have chronic illnesses like asthma, psoriasis, and autoimmune diseases.
Is vitamin D test expensive?
Without health insurance, a 25-hydroxyvitamin D test can cost anywhere from $15 to $263, with a national average of $132. For people without health insurance, vitamin D 1,23-dihydroxy tests can cost anywhere from $75 to $499.
Vitamin D testing costs vary depending on the location, institution, and type of vitamin D test.