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ICD-10-CM R79.0, Abnormal level of blood mineral | No Prior Auth

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`R79.0`, Abnormal level of blood mineral

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

This article provides billing, coding and guideline information that complements Local Coverage Determination (LCD) L33431 for HbA1c; refer to LCD L33431 for clinical coverage criteria and specific documentation requirements.
Medical records must document the medical necessity of the serum magnesium test, including the signs, symptoms, and/or diagnosis that prompted the test.
Laboratories must maintain the physician's order for the serum magnesium test in their records.
Medical records must contain the serum magnesium lab test results.

Key Coverage Criteria

No specific clinical indications are listed in this article; follow the Local Coverage Determination (LCD) L39400 for indications for magnesium testing or services.
E29.1 (Testicular hypofunction)
E80.1 (Porphyria cutanea tarda)
D75.1 (Secondary polycythemia)
Erythrocytosis of undetermined etiology where the hematocrit is 55 % or higher
Hemochromatosis (including hereditary hemochromatosis)

8 Active Policies

ANTHEM-CG-LAB-21, Serum Iron Testing

ANTHEM-CG-MED-90, Chelation Therapy

ANTHEM-CG-LAB-25, Outpatient Glycated Hemoglobin and Protein Testing

AMBETTER-CG-Gastro-Disorders-NonCa-2025.1, Concert Genetic Testing: Gastroenterologic Disorders (non-cancerous)

AETNA-CPB-0652, Therapeutic Phlebotomy

Related Codes

R78.79(5 policies)R78.71(5 policies)R79.89(4 policies)K91.2(4 policies)E79.0(4 policies)R78.89(4 policies)E83.19(4 policies)R79.9(4 policies)

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When requesting individual consideration through written redetermination, providers must include all relevant medical records and supporting literature.

For redetermination, providers must submit at minimum two (2) Phase II studies or one (1) Phase III study to support the request.

A56686, Billing and Coding: HbA1c

A57189, Billing and Coding: Serum Magnesium

A59186, Billing and Coding: Magnesium