80178, 82108, 82175, 82300, 82495, 82525, 83015, 83018, 83655, 83785, 83825, 83885, 84255, 84285, 84630, 84999
Aluminum – 82108 Alpha Sort
585.1-585.9 Chronic Kidney Disease (CKD) 292.81 Drug Induced Delirium
292.84 Drug Induced Mood Disorder
292.83 Drug Induced Persisting Amnestic Disorder 292.82 Drug Induced Persisting Dementia
996.73 Other Complications Due to Renal Dialysis Device Implant and Graft
294.8 Other Persistent Mental Disorders Due to Conditions Classified Elsewhere
292.89 Other Specified Drug Induced Mental Disorders 292.2 Pathological Drug Intoxication
973.0 Poisoning by Antacids and Antigastric Secretion Drugs 985.8 Toxic Effect of Other Specified Metals
293.9 Unspecified Transient Mental Disorder in Conditions Classified Elsewhere
Numeric Sort
292.2 292.83 293.9 973.0
292.81 292.84 294.8 985.8
292.82 292.89 585.1-585.9 996.73
Antimony - 83018
085.9 Leishmaniasis Unspecified
985.4 Toxic Effect of Antimony and its Compounds Numeric Sort
085.9 985.4
Arsenic – 82175 Alpha Sort
582.9 Chronic Glomerulonephritis with Unspecified Pathological Lesion in Kidney
692.4 Contact Dermatitis and Other Eczema Due to Other Chemical Products
Arsenic – 82175 Continued 787.91 Diarrhea
348.30 Encephalopathy Unspecified 356.0 Hereditary Peripheral Neuropathy 783.21 Loss of Weight
348.31 Metabolic Encephalopathy 787.01 Nausea with Vomiting 348.39 Other Encephalopathy
284.89 Other Specified Aplastic Anemias 569.89 Other Specified Disorders of Intestines 961.1 Poisoning by Arsenical Anti-Infectives 357.7 Polyneuropathy Due to Other Toxic Agents 985.1 Toxic Effect of Arsenic and its Compounds 356.9 Unspecified Idiopathic Peripheral Neuropathy Numeric Sort
284.89 348.39 357.7 692.4
787.91
348.30 356.0 569.89 783.21
961.1
348.31 356.9 582.9 787.01
985.1 Barium – 83015, 83018 Alpha Sort
518.89 Other Diseases of Lung Not Elsewhere Classified 985.8 Toxic Effect of Other Specified Metals
Numeric Sort
518.89 985.8
Beryllium – 83015, 83018 Alpha Sort
518.89 Other Diseases of Lung Not Elsewhere Classified 985.3 Toxic Effect of Beryllium and its Compounds Numeric Sort
518.89 985.3
Heavy Metal Testing
80178, 82108, 82175, 82300, 82495, 82525, 83015, 83018, 83655, 83785, 83825, 83885, 84255, 84285, 84630, 84999
Bismuth – 83015, 83018 Alpha Sort
289.7 Methemoglobinemia
523.8 Other Specified Periodontal Diseases 733.10 Pathological Fracture, Unspecified Site 985.8 Toxic Effect of Other Specified Metals Numeric Sort
289.7 523.8 733.10 985.8
Cadmium – 82300 Alpha Sort
518.89 Other Diseases of Lung, Not Elsewhere Classified 586 Renal Failure, Unspecified
985.5 Toxic Effect of Cadmium and its Compounds Numeric Sort
518.89 586 985.5
Chromium – 82495 Alpha Sort
518.89 Other Diseases of Lung, Not Elsewhere Classified 985.6 Toxic Effect of Chromium
Numeric Sort
518.89 985.6
Cobalt – 84999 Alpha Sort
518.89 Other Diseases of Lung, Not Elsewhere Classified 985.8 Toxic Effect of Other Specified Metals
Numeric Sort
518.89 985.8
Copper – 82525 Alpha Sort
571.40 Chronic Hepatitis, Unspecified 571.41 Chronic Persistent Hepatitis 571.5 Cirrhosis of Liver without Alcohol 275.1 Disorders of Copper Metabolism
783.3 Feeding Difficulties and Mismanagement
518.89 Other Diseases of Lung, Not Elsewhere Classified 790.5 Other Nonspecific Abnormal Serum Enzyme Levels 759.89 Other Specified Congenital Anomalies
586 Renal Failure, Unspecified
425.9 Secondary Cardiomyopathy, Unspecified 985.8 Toxic Effect of Other Specified Metals
571.9 Unspecified Chronic Liver Disease without Alcohol 573.9 Unspecified Disorder of Liver
Numeric Sort
275.1 571.40 571.9 759.89
985.8
425.9 571.41 573.9 783.3
518.89 571.5 586 790.5
Lead – 83655 Alpha Sort
348.30 Encephalopathy, Unspecified 356.0 Hereditary Peripheral Neuropathy 356.2 Hereditary Sensory Neuropathy 356.4 Idiopathic Progressive Polyneuropathy 348.31 Metabolic Encephalopathy
355.8 Mononeuritis of Lower Limb Unspecified 355.9 Mononeuritis of Unspecified Site
354.9 Mononeuritis of Upper Limb Unspecified
793.7 Nonspecific (Abnormal) Findings on Radiological and Other Examination of Musculoskeletal System 790.09 Other Abnormality of Red Blood Cells
348.39 Other Encephalopathy
354.8 Other Mononeuritis of Upper Limb
Heavy Metal Testing
80178, 82108, 82175, 82300, 82495, 82525, 83015, 83018, 83655, 83785, 83825, 83885, 84255, 84285, 84630, 84999
Lead – 83655 Continued
356.8 Other Specified Idiopathic Peripheral Neuropathy 356.1 Peroneal Muscular Atrophy
790.01 Precipitous Drop in Hematocrit 356.3 Refsum's Disease
984.0 Toxic Effect of Inorganic Lead Compounds 984.1 Toxic Effect of Organic Lead Compounds 984.8 Toxic Effect of Other Lead Compounds 984.9 Toxic Effect of Unspecified Lead Compound 356.9 Unspecified Idiopathic Peripheral Neuropathy Numeric Sort
348.30 355.8 356.3 790.09
984.9
348.31 355.9 356.4 793.7
348.39 356.0 356.8 984.0
354.8 356.1 356.9 984.1
354.9 356.2 790.01 984.8
Lithium – 80178 Alpha Sort
296.82 Atypical Depressive Disorder 296.81 Atypical Manic Disorder 296.80 Bipolar Disorder, Unspecified
296.56 Bipolar I Disorder, Most Recent Episode (or Current) Depressed, in Full Remission
296.55 Bipolar I Disorder, Most Recent Episode (or Current) Depressed, In Partial or Unspecified Remission 296.51 Bipolar I Disorder, Most Recent Episode (or Current)
Depressed, Mild
296.52 Bipolar I Disorder, Most Recent Episode (or Current) Depressed, Moderate
296.54 Bipolar I Disorder, Most Recent Episode (or Current) Depressed, Severe, Specified as with Psychotic Behavior 296.53 Bipolar I Disorder, Most Recent Episode (or Current)
Depressed, Severe, without Mention of Psychotic Behavior
Lithium – 80178 Continued
296.50 Bipolar I Disorder, Most Recent Episode (or Current) Depressed, Unspecified
296.46 Bipolar I Disorder, Most Recent Episode (or Current) Manic, In Full Remission
296.45 Bipolar I Disorder, Most Recent Episode (or Current) Manic, in Partial Or Unspecified Remission
296.41 Bipolar I Disorder, Most Recent Episode (or Current) Manic, Mild
296.42 Bipolar I Disorder, Most Recent Episode (or Current) Manic, Moderate
296.44 Bipolar I Disorder, Most Recent Episode (or Current) Manic, Severe, Specified As With Psychotic Behavior 296.43 Bipolar I Disorder, Most Recent Episode (or Current)
Manic, Severe, Without Mention Of Psychotic Behavior 296.40 Bipolar I Disorder, Most Recent Episode (or Current)
Manic, Unspecified
296.66 Bipolar I Disorder, Most Recent Episode (or Current) Mixed, in Full Remission
296.65 Bipolar I Disorder, Most Recent Episode (or Current) Mixed, in Partial or Unspecified Remission
296.61 Bipolar I Disorder, Most Recent Episode (or Current) Mixed, Mild
296.62 Bipolar I Disorder, Most Recent Episode (or Current) Mixed, Moderate
296.64 Bipolar I Disorder, Most Recent Episode (or Current) Mixed, Severe, Specified as with Psychotic Behavior 296.63 Bipolar I Disorder, Most Recent Episode (or Current) Mixed, Severe, without Mention of Psychotic Behavior 296.60 Bipolar I Disorder, Most Recent Episode (or Current)
Mixed, Unspecified
296.7 Bipolar I Disorder, Most Recent Episode (or Current) Unspecified
296.06 Bipolar I Disorder, Single Manic Episode, in Full Remission
Heavy Metal Testing
80178, 82108, 82175, 82300, 82495, 82525, 83015, 83018, 83655, 83785, 83825, 83885, 84255, 84285, 84630, 84999
Lithium – 80178 Continued
296.05 Bipolar I Disorder, Single Manic Episode, in Partial or Unspecified Remission
296.01 Bipolar I Disorder, Single Manic Episode, Mild 296.02 Bipolar I Disorder, Single Manic Episode, Moderate 296.04 Bipolar I Disorder, Single Manic Episode, Severe,
Specified as with Psychotic Behavior
296.03 Bipolar I Disorder, Single Manic Episode, Severe, without Mention of Psychotic Behavior
296.00 Bipolar I Disorder, Single Manic Episode, Unspecified 311 Depressive Disorder not Elsewhere Classified V58.83 Encounter For Therapeutic Drug Monitoring
V58.63 Long-term (Current) use of Antiplatelets/Antithrombotics V58.64 Long-term (Current) use of Nonsteroidal
Anti-Inflammatories
V58.69 Long-term (Current) use of Other Medications V58.65 Long-term (Current) use of Steroids
296.36 Major Depressive Affective Disorder Recurrent Episode in Full Remission
296.35 Major Depressive Affective Disorder Recurrent Episode in Partial or Unspecified Remission
296.31 Major Depressive Affective Disorder Recurrent Episode Mild Degree
296.32 Major Depressive Affective Disorder Recurrent Episode Moderate Degree
296.34 Major Depressive Affective Disorder Recurrent Episode Severe Degree Specified as with Psychotic Behavior 296.33 Major Depressive Affective Disorder Recurrent Episode
Severe Degree without Psychotic Behavior
296.30 Major Depressive Affective Disorder Recurrent Episode Unspecified Degree
296.26 Major Depressive Affective Disorder Single Episode in Full Remission
296.25 Major Depressive Affective Disorder Single Episode in Partial or Unspecified Remission
296.21 Major Depressive Affective Disorder Single Episode Mild Degree
Lithium – 80178 Continued
296.22 Major Depressive Affective Disorder Single Episode Moderate Degree
296.24 Major Depressive Affective Disorder Single Episode Severe Degree Specified as with Psychotic Behavior 296.23 Major Depressive Affective Disorder Single Episode
Severe Degree without Psychotic Behavior
296.20 Major Depressive Affective Disorder Single Episode Unspecified Degree
296.16 Manic Affective Disorder Recurrent Episode in Full Remission
296.15 Manic Affective Disorder Recurrent Episode in Partial or Unspecified Remission
296.11 Manic Affective Disorder Recurrent Episode Mild Degree 296.12 Manic Affective Disorder Recurrent Episode Moderate
Degree
296.14 Manic Affective Disorder Recurrent Episode Severe Degree Specified as with Psychotic Behavior 296.13 Manic Affective Disorder Recurrent Episode Severe
Degree without Psychotic Behavior
296.10 Manic Affective Disorder Recurrent Episode Unspecified Degree
296.89 Other and Unspecified Bipolar Disorders, Other 296.99 Other Specified Episodic Mood Disorder
969.8 Poisoning by Other Specified Psychotropic Agents 985.8 Toxic Effect of Other Specified Metals
296.90 Unspecified Episodic Mood Disorder
Heavy Metal Testing
80178, 82108, 82175, 82300, 82495, 82525, 83015, 83018, 83655, 83785, 83825, 83885, 84255, 84285, 84630, 84999
Lithium – 80178 Numeric Sort
296.00 296.11 296.22 296.33
296.44 296.55 296.66
311
296.01 296.12 296.23 296.34
296.45 296.56 296.7
969.8
296.02 296.13 296.24 296.35
296.46 296.60 296.80
985.8
296.03 296.14 296.25 296.36
296.50 296.61 296.81
V58.63
296.04 296.15 296.26 296.40
296.51 296.62 296.82
V58.64
296.05 296.16 296.30 296.41
296.52 296.63 296.89
V58.65
296.06 296.20 296.31 296.42
296.53 296.64 296.90
V58.69
296.10 296.21 296.32 296.43
296.54 296.65 296.99
V58.83
Heavy Metal Testing
80178, 82108, 82175, 82300, 82495, 82525, 83015, 83018, 83655, 83785, 83825, 83885, 84255, 84285, 84630, 84999
Manganese – 83785 Alpha Sort
783.3 Feeding Difficulties and Mismanagement
333.99 Other Extrapyramidal Diseases and Abnormal Movement Disorders
985.2 Toxic Effect of Manganese and its Compounds 333.90 Unspecified Extrapyramidal Diseases and Abnormal
Movement Disorder Numeric Sort
333.90 333.99 783.3 985.2
Mercury – 83825 Alpha Sort
438.84 Ataxia
334.4 Cerebellar Ataxia in Diseases Classified Elsewhere 334.0 Friedreich's Ataxia
781.3 Lack Of Coordination 334.3 Other Cerebellar Ataxia
333.99 Other Extrapyramidal Diseases And Abnormal Movement Disorders
961.2 Poisoning by Heavy Metal Anti-Infectives
976.8 Poisoning by Other Agents Primarily Affecting Skin and Mucous Membrane
973.3 Poisoning by Other Cathartics Including Intestinal Atonia 586 Renal Failure, Unspecified
985.0 Toxic Effect of Mercury and its Compounds
333.90 Unspecified Extrapyramidal Disease and Abnormal Movement Disorder
Numeric Sort
333.90 438.84 976.8
333.99 586 985.0
334.0 781.3
334.3 961.2
334.4 973.3
Molybdenum – 84999 Alpha Sort
985.8 Toxic Effect of Other Specified Metals Numeric Sort
985.8
Nickel – 83885 Alpha Sort
518.89 Other Diseases of Lung Not Elsewhere Classified 586 Renal Failure, Unspecified
985.8 Toxic Effect of Other Specified Metals Numeric Sort
518.89 586 985.8
Selenium – 84255 Alpha Sort
586 Renal Failure, Unspecified
985.8 Toxic Effect of Other Specified Metals Numeric Sort
586 985.8
Thallium – 84999 Alpha Sort
781.3 Lack of Coordination
357.7 Polyneuropathy Due to Other Toxic Agents 985.8 Toxic Effect of Other Specified Metals Numeric Sort
357.7 781.3 985.8
Heavy Metal Testing
80178, 82108, 82175, 82300, 82495, 82525, 83015, 83018, 83655, 83785, 83825, 83885, 84255, 84285, 84630, 84999
Tin – 84999 Alpha Sort
985.8 Toxic Effect of Other Specified Metals Numeric Sort
985.8
Titanium – 84999 Alpha Sort
985.8 Toxic Effect of Other Specified Metals Numeric Sort
985.8
Zinc – 84630 Alpha Sort
783.3 Feeding Difficulties and Mismanagement 555.9 Regional Enteritis of Unspecified Site 586 Renal Failure, Unspecified
985.8 Toxic Effect of Other Specified Metals 579.9 Unspecified Intestinal Malabsorption Numeric Sort
555.9 579.9 586 783.3
985.8
ICD-9-CM codes that meet medical necessity guidelines for the following heavy metals have not been identified by WPS:
Boron Phosphorous
Silica (CPT Code 84285) Strontium
Sulfur Uranium Vanadium