HCPCS/CPT Codes. 76977 – Ultrasound bone density measurement and interpretation, peripheral site(s), any method. 77078 – Computed tomography, bone mineral density study, 1 or more sites; axial . skeleton (e.g., hips, pelvis, spine) 77080 – Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more
The new codes are for describing the infusion of tixagevimab and cilgavimab monoclonal antibody (code XW023X7), and the infusion of other new technology monoclonal antibody (code XW023Y7).
Search the full ICD-10 catalog by:
evaluation. When a bone biopsy is used for bone density measurement, the covered indications are the same as other covered studies. When the service is provided for a non-covered or screening indication, the appropriate screening diagnosis code must be submitted as the reason for the service. 3. ICD-10 CM code Z90.721 or Z90.722 should be reported for women s/p oophorectomy. ICD-10
ICD-10 CM code Z79. 83 should be reported for DXA testing while taking medicines for osteoporosis/osteopenia. ICD-10 CM code Z09 should be reported for an individual who has COMPLETED drug therapy for osteoporosis and is being monitored for response to therapy.
77080CodeDescriptionM85.841Other specified disorders of bone density and structure, right handM85.842Other specified disorders of bone density and structure, left handM85.851Other specified disorders of bone density and structure, right thighM85.852Other specified disorders of bone density and structure, left thigh124 more rows
According to a Medicare National Coverage Determinations Coding Policy Manual and Change Report (ICD-10-CM), Z13. 820 Encounter for screening for osteoporosis is not covered by Medicare for a diagnostic lab testing service.
Medicare will always deny Z13. 820 if it is the primary or only diagnosis code.
ICD-10 Code for Disorder of bone density and structure, unspecified- M85. 9- Codify by AAPC.
Billing CPT 77080, 77081, 77082 with covered dxREIMBURSEMENT CODES FOR BONE DENSITOMETRY.CPT Code 77080 – Hip, spine or central DEXA (Dual Energy X-Ray Absorptiometry) studies. ... CPT Code 77081 – Peripheral DEXA Bone Mineral Density – $27.72.CPT Code 77082 – Peripheral Ultrasound Bone Mineral Density.Indications for DEXA.
Bone mass measurements (also called bone density tests) can help determine if you need medical treatment for osteoporosis, a condition that can cause brittle bones in older adults. Medicare Part B covers bone mass measurement every two years if you are at risk for osteoporosis and have a referral from your provider.
In most cases, Medicare insurance does cover DEXA scans under Part B. Medicare Part B (Medical Insurance) provides benefits for outpatient procedures that are deemed medically necessary for ongoing treatment of illness.
NOTE: Prior approval for CPT 77078 (Computed tomography, bone mineral density study, 1 or more sites; axial skeleton (e.g., hips, pelvis, spine) is managed by eviCore.
A DEXA scan is a type of medical imaging test. It uses very low levels of x-rays to measure how dense your bones are. DEXA stands for “dual-energy X-ray absorptiometry.” Medical experts consider DEXA scans to be the most useful, easy, and inexpensive test for helping to diagnose osteoporosis.
DXA is most often used to diagnose osteoporosis, a condition that often affects women after menopause but may also be found in men and rarely in children. Osteoporosis involves a gradual loss of bone, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break.
The most common, accurate method to measure bone density involves dual energy X-ray absorptiometry (DXA). DXA projects two X-ray beams to better assess bone density and can detect a variance as small as 3 percent from one scan to the next. Conventional X-rays are not sensitive enough to detect such small variances. DXA is especially effective for full-body skeletal assessments, as well as for focused studies of the hip, spinal column, and forearm (the skeletal areas most likely to break).#N#During a DXA scan, the patient rests on a cushioned platform. Mechanical arms are placed under the X-ray table and are aligned with an X-ray detector placed above the patient’s body. The amount of X-ray energy absorbed by the bone is measured to determine the strength of that bone. Less energy will pass through healthy bone than through osteopenic or osteoporotic bone.#N#Aside from using DXA, a bone density study might be conducted using:
Aside from using DXA, a bone density study might be conducted using: Peripheral DXA (pDXA) – Portable machines used to measure bone density in the arms or legs.
Common diagnoses resulting from bone density studies may be reported with the following ICD-9-CM codes from Category 733 Other disorders of bone and cartilage:#N#733.0x Osteoporosis#N#733.1x Pathologic fracture#N#733.9x Other and unspecified disorders of bone and cartilage#N#Bone pain and other bone disorders may be coded from Category 719 Other and unspecified disorders of joint; or#N#733.90 Disorder of bone and cartilage, unspecified.#N#Report personal or family history of bone disorders with:#N#V13.89 Personal history of other specified diseases;#N#V17.81 Family history of osteoporosis; or#N#V17.89 Family history of other musculoskeletal disease.#N#Example 1: A 59-year-old man presents to his primary care physician (PCP) with the chief complaint of creaking knees: His knees ache and pop every time he rises from his living room sofa. He also has heard and felt occasional snaps in his groin and shoulder blades. The PCP does a limited exam of these three regions and orders bilateral X-rays of these regions.#N#CPT® codes:
Age is a key factor because the older a person gets, the more bone he or she tends to lose (reflected in ICD-9-CM classification as “Senile,” and in ICD-10-CM as “Age-related”). Gender is also a factor. Women are more prone to osteoporosis because they have smaller bones than men.
Quantitative ultrasound (QUS) – A portable machine used to measure bone density of the heel. Radiographic absorptiometry (RA) – This technique is most commonly used for bone density measurement at the hand or heel.
Mechanical arms are placed under the X-ray table and are aligned with an X-ray detector placed above the patient’s body. The amount of X-ray energy absorbed by the bone is measured to determine the strength of that bone. Less energy will pass through healthy bone than through osteopenic or osteoporotic bone.
You break a bone after age 50. You are a woman of menopausal age with risk factors. You are a postmenopausal woman under age 65 with risk factors. You are a man age 50-69 with risk factors. Or a physician might order a bone density study for a patient who has had: An X-ray showing a spinal break or bone loss. Back pain.
DXA can also be used to measure peripheral sites, such as the wrist and finger. DXA generates 2 x-ray beams of different energy levels to scan the region of interest and measure the difference in attenuation as the low- and high-energy beams pass through the bone and soft tissue.
Priority Health will limit coverage for BMD studies to central DXA only. Any other BMD studies (e.g. peripheral, such as wrist, finger and heel) are not medically/clinically necessary and, therefore, not covered. BMD studies will not be prior authorized by Priority Health.
2. An individual with vertebral abnormalities as demonstrated by an x-ray to be indicative of osteoporosis, osteopenia, or vertebral fracture. 3. An individual receiving (or expecting to receive) glucocorticoid (steroid) therapy. 4. An individual with primary hyperparathyroidism.
Medicare will cover DEXA bone mass measurement once every 2 years on a person who falls into 1 out of the 5 Following categories: 1. A woman who has been determined by her physician to be estrogen-deficient and at clinical risk for osteoporosis. 2.
A. A one-time measurement of BMD, using one method only, may be considered medically necessary to assess fracture risk and the need for pharmacologic therapy in the following patients considered at risk for osteoporosis, who are also considering treatment to prevent osteoporotic fracture: 1.
Medicare reimbursement for an initial bone mass measurement may be allowed only once, regardless of sites studied (e.g., if the spine and hip are studied, Procedure code 77080 should be billed only once).
BCBSNC will provide coverage for Axial (Central) Bone Mineral Density (BMD) Studies when they are determined to be medically necessary because the medical criteria and guidelines shown below are met.
Bone density screening is also known as bone density screening , femoral neck dual energy X-ray photon absorptiometry scan result osteopenic, femoral neck dual energy X-ray photon absorptiometry scan result osteoporotic, forearm DXA scan result osteopenic, hip DXA scan result osteopenic, quantitative ultrasound scan of heel – result osteoporotic, screening for osteoporosis, and screening for osteoporosis done..
Bone density screening is a very simple, non invasive test that measures a person’s bone density or volume of calcium and other minerals within the bone.