What are the coverage guidelines for B-12 injections?
CIGNA Government Services retired the Idaho, Tennessee, and North Carolina local coverage determinations for B-12 effective 090106. The Centers for Medicaid and Medicare Services still state in CMS Publication 100-2, the Medicare Benefit Manual, Chapter 15, section 50 that the use of a drug or biological is “reasonable and necessary for the diagnosis or treatment of the illness or injury for which they are administered according to accepted standards of medical practice.” Also, in the same chapter under section 50.4.3, it states “Medications given for a purpose other than the treatment of a particular condition, illness, or injury are not covered (except for certain immunizations). Charges for medications, e.g., vitamins, given simply for the general good and welfare of the patient and not as accepted therapies for a particular illness are excluded from coverage.” An example of accepted standard of practice and covered B-12 therapy would be the maintenance treatment of pernicious anemi
