Did you know that almost 1 billion people around the world are affected with Vitamin D Deficiency…
Yet it has become one of the most common issues seen in primary care today. Routine blood tests and chronic fatigue diseases even need vitamin level testing, and in such a situation, using the right ICD 10 Vitamin D Deficiency code will help you a lot. In this blog, we’re going to learn about the code E55.9, when to use it, and how to avoid billing errors + other CPT codes and screening rules that are related to it.
What is the Deficiency of Vitamin D?
This means that your body has a vitamin D deficiency and it is an important nutrient for the body to work properly. This usually occurs when you are not in the sunlight long enough or you are not consuming foods that contain vitamin D. It is actually not as uncommon as you may think, and it can happen to anyone regardless of his or her age.
Symptoms of Vitamin D Deficiency
- Chronic fatigue or tiredness
- Bone or joint pain
- Muscle cramps
- Frequent infections
- Mood changes
- Hair loss (in some cases)
Some Common Causes…
- Not spending enough time in the sun
- Having a poor diet
- Obesity
- Chronic kidney
- Liver diseases
- Malabsorption disorders like, celiac disease, Crohn’s disease
- Certain medications like the anticonvulsants or glucocorticoids
Diagnosis Criteria
A Vitamin D blood test (25-hydroxyvitamin D) measures the levels of vitamin D. This table will help you understand it.
| 25(OH)D Level | Interpretation |
| < 20 ng/mL | Deficiency |
| 20–30 ng/mL | Insufficiency |
| 30–50 ng/mL | Optimal |
| > 100 ng/mL | Possible Toxicity |
What is E55.9? The ICD 10 Code for Vitamin D Deficiency…
E55.9 is the ICD-10 code for vitamin D deficiency. It is used when a patient has low vitamin D levels, but the actual cause of the deficiency is not mentioned in any documents. This is also a billable code that is widely used in primary health care, endocrinology, and general practice.
That means different terms like hypovitaminosis D (ICD 10), vitamin D insufficiency, or low vitamin D are billed under the same code, as the reason is still unknown.
When and When Not to Use E55.9
It is important to know when to use the ICD-10 Code (E55.9) for proper diagnosis and to avoid any claim denials. It should not be used as a proxy when screening or supplementing patients, but only when there is clinical evidence of the deficiency.
When to Use E55.9
ICD-10-CM code (E55.9) should only be used in certain conditions. Some of them are discussed below.
- The patient should have the following symptoms
1. Fatigue
2. Bone pain
3. Muscle weakness, etc.
- 25-hydroxyvitamin D level < 20 ng/mL (Lab tests show Deficiency in vitamin D levels)
When Not to Use E55.9
You should not use E55.9 in the following scenarios:
1. Preventive Screening
If a patient has a routine checkup or general screening, then the right code to use is:
- Z13.21 – Screening code for detecting vitamin or nutrient deficiencies.
2. Supplementation Without Testing
Do not use E55.9 if:
- The patient is taking over-the-counter vitamin D as a general supplement
- No lab test has confirmed a deficiency
- No symptoms or signs are documented related to the deficiency
Tip: Always Link E55.9 with Lab Documentation
To avoid coding errors and denials:
- The medical documents should always contain a 25-hydroxyvitamin D lab test report.
- Ensure clinical notes explain the symptoms or medical necessity
- Don’t use E55.9 as a “default” for all vitamin D discussions, only for confirmed deficiencies
Screening for Vitamin D Deficiency – Z13.21
In case you are ordering a lab work to test vitamin D level without having any symptoms, the appropriate code to be utilized is Z13.21 Encounter of screening nutritional deficiency. This ICD-10 code is applied specifically when the reason for the visit is preventive and is not related to a diagnosed condition.
That is, when the patient is healthy and you are only checking to see that the levels are low, use Z13.21 as the appropriate ICD-10 code for vitamin D screening.
Medicare’s Stance on Preventive Vitamin D Testing
Vitamin D testing is not covered by Medicare during routine screening unless there is a medically necessary purpose. That means:
- If you are using E55.9 to justify routine lab work, there’s a high chance that your claim could be denied.
- Z13.21 should only be used when screening is done without any symptoms, and even then, you must verify whether the payer covers it
To have an insurance plan (including Medicare) reimburse the cost of vitamin D testing, most policies (including Medicare) require a documented symptom or risk factor, such as fatigue, bone loss, or some chronic diseases.
Improper Use of E55.9 = Denied Claims
Using E55.9 when a deficiency hasn’t been diagnosed can flag your claim as inaccurate or not medically necessary. For example:
- If you list E55.9 during a preventive visit with no symptoms or lab confirmation, it may be considered fraudulent coding
- If Medicare or a private payer reviews the chart and sees no lab evidence or clinical signs, the claim will likely be denied or flagged
To stay compliant:
- Use Z13.21 for screening
- Use E55.9 only when there’s a confirmed deficiency
Always match the ICD 10 screening for vitamin D deficiency with proper CPT codes (like 82306) and supporting documentation.
CPT Codes for Vitamin D Testing…
When a doctor checks your vitamin D levels, they usually request a test called 25-hydroxyvitamin D. It’s the most common one. To make sure the insurance covers it without delay, the right CPT code needs to be used. There are other codes too, depending on the kind of test done.
Here’s a complete list of CPT codes related to Vitamin D testing:
Common CPT Codes for Vitamin D
| CPT Code | Test Name | Description |
| 82306 | Vitamin D; 25-hydroxy | The most widely applied test is a test that is used to determine the status of vitamin D (D2 + D3). It is both screening and diagnostic. |
| 82652 | Vitamin D; 1,25-dihydroxy | A special test is employed in case of suspected hypercalcemia, kidney problems, or any other metabolic mess. |
| 83516 | Immunoassay | Sometimes used in labs that utilize this method for vitamin D-related hormone levels. Not specific to vitamin D alone, but occasionally bundled. |
| 004335 (Labcorp) | Vitamin D, 25-Hydroxy, Total, Immunoassay | A lab-specific panel test for vitamin D – CPTs varies based on the lab and methodology. |
| 005199 (Labcorp) | Vitamin D, 1,25-Dihydroxy | Lab-specific variation for the 1,25 test (linked to CPT 82652). |
| 006049 (Quest) | Vitamin D, 25-Hydroxy, LC/MS/MS | The advanced testing method is often coded as 82306, but can vary with payer/lab. |
| 006118 (Quest) | Vitamin D, 1,25-Dihydroxy | Often aligned with CPT 82652, specific to Quest Labs. |
Note: There are internal codes or test panels used in some labs (Labcorp, Quest, etc.). When you use third-party lab services, always check what CPT is being billed.
Related ICD-10 Codes for Vitamin D
In most instances, doctors end up applying E55.9 when diagnosing a lack of vitamin D. Other codes would, however, be applied based on what the patient is experiencing, including some symptoms, treatment history, or laboratory findings. It is not all about paperwork but also assists in ensuring that the information is clear when it comes to billing and insurance purposes.
There are also a few other ICD-10 codes that relate to vitamin D or similar metabolic issues. Here’s a quick look:
Common ICD-10 Codes for Vitamin D and Related Conditions
| ICD Code | Description |
| E55.0 | Rickets due to Vitamin D deficiency (It is used when there is a deficiency, which results in skeletal deformities, especially in children) |
| E55.9 | Unspecified Vitamin D deficiency (It is the most commonly used code if the cause isn’t known) |
| Z13.21 | Screening for nutritional deficiency (It is used to order tests without a confirmed diagnosis) |
| E83.51 | Disorders of calcium metabolism (sometimes paired with vitamin D deficiency, especially in endocrine disorders) |
| Z91.120 | Patient noncompliance with dietary therapy (Useful if a deficiency persists due to the patient’s behaviour) |
| M83.0 | Adult osteomalacia due to Vitamin D deficiency (It is rarely used, but applicable in advanced or chronic cases) |
| D89.2 | Disorders involving the immune mechanism, not elsewhere classified (May relate if the deficiency affects immune function.) |
Documentation & Billing Tips
Here are some documentation and billing tips related to the use of ICD-10 code E55.9…
What Justifies Use of E55.9?
Only on the basis of the following, E55.9 (Unspecified Vitamin D Deficiency) can be assigned correctly to the medical record:
- A lab report of 25-hydroxyvitamin D that indicates low vitamin D status in the body (usually less than 20 ng/mL)
- The related symptoms of this are mentioned in the medical records (e.g., fatigue, pain, bone ache, weak muscles)
- Provider interpretation of lab results or diagnosis, not just the lab report itself
Tip: The physician’s note should mention “Vitamin D deficiency” explicitly, even if lab results are attached.
Always include:
- Test date
- Lab value
- Reference range
- Provider’s interpretation (in the chart note)
Medicare Coverage Guidance
The CMS (Centers for Medicare & Medicaid Services) limits coverage of Vitamin D testing to medical necessity; this implies a diagnosis such as E55.9 should be accompanied by all symptoms, laboratory findings, and justified need to test or treat to be covered.
Source:
CMS Article A57718 – Vitamin D Assay Testing
Commonly Asked Questions (FAQs)
What is diagnosis code E55.9 used for?
Unspecified Vitamin D deficiency is diagnosed with the ICD-10 code E55.9 in confirmed cases. It is usually used when the provider records clinical manifestations and the laboratory test reveals low vitamin D concentrations (normally < 20 ng/mL).
Can I use E55.9 for Vitamin D insufficiency?
Not exactly. Although the ICD-10 code vitamin D insufficiency is not a distinct code, mild or borderline low levels are not to be coded as E55.9 unless the provider provides clinical support. E55.9 is intended to be used in regard to true deficiency, and not general low levels or prophylaxis.
What’s the ICD 10 code for Vitamin D screening?
When screening without symptoms or confirmed deficiency, code Z13.21 should be used – this is the correct ICD-10 code for Vitamin D screening. It is used when the patient is undergoing a check-up or a well visit.
What CPT code goes with Vitamin D testing?
The most common CPT code that is utilized when Vitamin D is under test is the 82306 that is utilized to test the 25-hydroxyvitamin D. It is a test that identifies the level of D2 and D3. This code can be used with either E55.9 or Z13.21, in case this is either screening or diagnostic.
Is Vitamin D deficiency covered under Medicare?
Well, not so much, but with terms. The coverage of testing is on a valid medical basis i.e. fatigue, osteoporosis or documented low levels of vitamin D and the diagnosis code E55.9 has been documented as valid. However, clinically unindicated Vitamin D (ICD 10 Z13.21) screening is not normally covered.
What’s the ICD 10 code for Vitamin D 25-hydroxy testing?
Vitamin D 25-hydroxy lacks a particular ICD-10 code. Based on the indication of the test or ordering of the test, you are to use E55.9 (when there is a confirmed deficiency) or Z13.21 (when it is a screening). CPT code is also the same, 82306.
For another frequently used diagnosis code, explore our guide on ICD-10 R35.0 for Urinary Frequency.
