dexa scan icd 10 code for medicare

by Ms. Martine Bailey MD Published 3 years ago Updated 2 years ago 6 min read

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.

What diagnosis will Medicare cover for a DEXA scan?

Oct 10, 2021 · What Icd 10 Codes Cover A Dexa Scan 4.2/5 ICD 10 code DXA ICD 10 code answer here Encounter for screening for osteoporosisZ13. 820 is a billable/specific ICD-10-CM code …

How often do I need a DEXA scan?

In addition to the many ICD-10 codes for fracture, the following diagnosis codes, when used with a DXA Bone Scan (77080) will be accepted and paid by Medicare: Z78.0. Asymptomatic …

What do you wear when you get a DEXA scan?

Oct 01, 2021 · Z13.820 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM Z13.820 became …

Is DEXA scan and bone scan same thing?

The following ICD-10-CM codes support medical necessity and provide limited coverage for CPT codes 77080, 77085, 0508T: It is the provider’s responsibility to select codes carried out to the …

What diagnosis covers DEXA scan for Medicare?

osteoporosis

Medicare will cover bone density scans for a person who meets certain medical requirements, such as osteoporosis risk factors. Identifying thinning bone or osteoporosis at early stages before a person breaks a bone can allow them to receive treatments that may help reduce the risk of broken bones.Oct 21, 2020

What ICD-10 code covers bone density?

Disorder of bone density and structure, unspecified

M85. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM M85. 9 became effective on October 1, 2021.

Is DEXA scan covered by Medicare?

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.

Is Z13 820 covered by Medicare?

Medicare will always deny Z13. 820 if it is the primary or only diagnosis code.Jun 5, 2016

Does Medicare cover bone mass measurement?

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.

Is a DEXA scan considered preventative?

The DEXA scan is the only scan that can diagnose osteoporosis before a fracture occurs. Treatment can prevent about half of the fractures caused by osteoporosis. A DEXA Scan gives you the knowledge to own your health.Oct 24, 2018

What is CPT code for DEXA scan?

Effective for dates of service on and after January 1, 2015, contractors shall pay for bone mass procedure code 77085 (Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites, axial skeleton, (e.g., hips, pelvis, spine), including vertebral fracture assessment.)Oct 26, 2018

What is the ICD 10 code for osteoporosis?

0 – Age-Related Osteoporosis without Current Pathological Fracture. ICD-Code M81. 0 is a billable ICD-10 code used for healthcare diagnosis reimbursement of Age-Related Osteoporosis without Current Pathological Fracture.

Does Medicare cover DXA bone densitometry?

Medicare covers DXA Bone Densitometry for certain Medicare beneficiaries who fall into at least one of the following categories: 1.) A woman whose doctor has determined she’s estrogen-deficient and at a clinical risk for osteoporosis, based on her medical history and other findings . 2.) Patient with vertebral abnormalities as demonstrated by x-ray ...

How often do you need a DXA for osteoporosis?

Medicare beneficiaries who meet the above criteria may have a Diagnostic DXA once every 24 months (more often if medically necessary).

How often do you need a DXA for a fracture?

Medicare beneficiaries who meet the above criteria may have a Diagnostic DXA once every 24 months (more often if medically necessary). In addition to the many ICD-10 codes for fracture, the following diagnosis codes, when used with a DXA Bone Scan (77080) will be accepted and paid by Medicare:

How often does Medicare cover dexa?

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.

What is the Medicare code for bone density?

Procedure code 77082 is considered by Medicare to represent vertebral fracture assessment only. Because code 77082 does not represent a BONE density study, when a BONE density study with vertebral fracture assessment is performed, bill the code for the appropriate BONE density study (e.g., 77080) plus code 77082.

What is DXA used for?

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.

Does diagnosis code guarantee coverage?

Documentation must be available upon request. It is the responsibility of the provider to code to the highest level specified. The correct use of a diagnos is code listed, does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified.

Is CPT 77085 covered by Medicare?

Member cost share will apply when medically necessary criteria are met. The following two studies are not covered by Medicare: * 78350: Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry.

Can Medicare reimburse bone mass?

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).

Does BCBSNC cover BMD?

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.