Our local Regence is denying all vitamin D testing, even with the code E55.9 stating it does not meet medical necessity. I have decided to try and appeal those who actually have vitamin D deficiency but what about those who have symptoms necessitating more screening lab like Vitamin D testing? Also, it appears that Regence has the whole charge as a contractual adjustment. Can we really not bill the patient for this lab (some patients request it). We are going to implement an ABN, but if we do not have one, can we still bill the patient? The EOBs are confusing as they list a contractual adjustment amount, and then then they add CO-50 which is the "does not meet medical necessity."