Serum - Gel. Clinical notes required- SEE COMMENTS SECTION.

Clinicians must provide an appropriate clinical justification for this test as of 01/11/2014.

 If a relevant clinical note is not provided, no Medicare reimbursement is claimable and the laboratory may not perform the test.

The new Medicare item for 25-hydroxyvitamin D is 66833 and will only attract a Medicare benefit if any of the eleven clinical criteria are met. 

The item definition (66833) from Medicare is: 25‑hydroxyvitamin D, quantification in serum, for the investigation of a patient who:

• (a) has signs or symptoms of osteoporosis or osteomalacia; or


• (b) has increased alkaline phosphatase and otherwise normal liver function tests; or


• (c) has hyperparathyroidism, hypo‑ or hypercalcaemia, or hypophosphataemia; or


• (d) is suffering from malabsorption (for example, because the patient has cystic fibrosis, short bowel syndrome, inflammatory bowel disease or untreated coeliac disease, or has had bariatric surgery); or


• (e) has deeply pigmented skin, or chronic and severe lack of sun exposure for cultural, medical, occupational or residential reasons; or


• (f) is taking medication known to decrease 25OH‑D levels (for example, anticonvulsants); or


• (g) has chronic renal failure or is arenal transplant recipient; or


• (h) is less than 16 years of age and has signs or symptoms of rickets; or


• (i) is an infant whose mother has established vitamin D deficiency; or


• (j) is an exclusively breastfed baby and has at least one other risk factor mentioned in a paragraph in this item; or


• (k) has a sibling who is less than 16 years of age and has vitamin D deficiency

Monday - Friday  08:30 - 17:00