Effective 02/01/2019, HMSA plans cover vitamin B-12 injections for treatment of the following conditions:
| Condition | ICD-10 Codes |
|---|---|
| Diphyllobothriasis | B70.0 |
| Malignant neoplasm | C16.0 - C16.9, C33 -C34.92, C37, C38.4, C48.2, C52, C53.0 – C53.9, C56.1 - C57.02, C61, C65.1 - C65.9, C66.1 - C66.9, C67.0 - C67.9, C68.0, C78.2 |
| Mesothelioma | C45.0, C45.1, C45.7 |
| Lymphoma | C82.50 - C82.59, C82.5A, C83.30 - C83.398, C83.3A, C84.40 - C84.49, C84.4A, C84.60 - C84.79, C84.7A, C84.7B, C84.A0 – C84.99, C84.9A, C85.10 - C86.61, C91.50 - C91.52 |
| Mycosis fungoides | C84.00 - C84.09 |
| Sezary disease | C84.10 - C84.19, C84.1A |
| Other lymphoid leukemia | C91.Z0 - C91.Z2 |
| Anemia | D51.0, D51.1 - D51.9, D52.0, D53.1, D53.9 |
| Deficiency of other specified B group vitamins | E53.8 |
| Methylmalonic acidemia | E71.120 |
| Homocystinuria | E72.11 |
| Disorders of glycine metabolism | E72.50-E72.53, E72.59-E72.9 |
| Other demyelinating diseases of central nervous system | G37.0 - G37.9 |
| Neuropathy | G62.1, G99.0, H46.3 |
| Disorders of autonomic nervous system | G90.01 - G90.9 |
| Retrobulbar neuritis (acute) | H46.10 - H46.13 |
| Adult hypertrophic pyloric stenosis | K31.1 |
| Intestinal obstruction | K31.5, K56.600 - K56.609 |
| Regional enteritis of small intestine | K50.00 - K50.019 |
| Fistula of intestine | K63.2 |
| Other specified diseases of intestine | K63.89 |
| Intestinal malabsorption | K90.0 - K90.9 |
| Postgastric surgery syndromes | K91.1 |
| Postsurgical malabsorption, not elsewhere classified | K91.2 |
| Intestinal bypass and anastamosis status | Z98.0 |
Note: Diagnoses not listed above are not covered. For example, vitamin B-12 injections are not covered when used to strengthen tendons, ligaments, etc. of the foot, and to treat arthritis, multiple sclerosis, senility, or delayed growth.
Claims Filing Information
Vitamin B-12 injections should be billed using the following HCPCS code:
- J3420 - Injection, vitamin B-12 Cyanocobalamin, up to 1000 mcg
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |