Medicare overhaul restricts vitamin D and B12 tests

The MBS items for vitamins D and B12 testing have been overhauled to confine their use to high-risk patients in a bid to prevent "screening".

MBS items 66608 and 66609 for vitamin D testing were abolished on  November 1 and replaced with new items that have specific clinical criteria.

The new 66833 item covers 25-hydroxyvitamin D testing for high-risk groups, such as people who have "deeply pigmented skin, or chronic and severe lack of sun exposure for cultural, medical, occupational or residential reasons". 

The item covers testing in 10 other high-risk categories, including patients with osteoporosis and those with malabsorption.

The restrictions were introduced after a Medicare review in February found there had been an almost 4,000% increase in vitamin D testing over the past decade, with most tests being requested with other items, suggesting they were for