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 2019 edition of ICD-10-CM M85.9 became effective on October 1, 2018.
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
The ICD-10 code range for ICD-10 Disorders of bone density and structure M80-M85 is medical classification list by the World Health Organization (WHO).
CPT Code 77080 was mainly used for bone density scan of axial bones like hips and spine while 77081 was used to code axial bone like wrist, radius and heel etc. These codes were deleted in 2015 and two new codes were introduced for DEXA scan. These CPT Codes will include the old codes.
cpt code 78350, 78351, 77080 and 77086 - Medical Billing and Coding - Procedure code, ICD CODE. 78350: Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry 78351: Bone density (bone mineral content) study, 1 or more sites; dual photon absorptiometry
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
Medicare beneficiaries who meet the above criteria may have a Diagnostic DXA once every 24 months (more often if medically necessary)....Updated DXA Policy for Medicare Patients.Z78.0Asymptomatic menopausal stateZ87.310Personal history of (healed) osteoporosis fracture4 more rows•Mar 6, 2017
This service must be performed using dual-energy X-ray absorptiometry system (axial skeleton)—CPT codes 77080 and 77085.”
Patients who qualify by statute for osteoporosis screening may be evaluated by studies that are characterized by CPT codes 77078, 77080, 77081, 77085, 76977, and G0130. The following is a list of ICD-10-CM codes that support the medical necessity of osteoporosis screening.
Encounter for screening for osteoporosis 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 effective on October 1, 2021.
Z13. 820 Encounter for screening for osteoporosis - ICD-10-CM Diagnosis Codes.
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 bone density scan uses low dose X-rays to see how dense (or strong) your bones are. You may also hear it called a DEXA scan. Bone density scans are often used to diagnose or assess your risk of osteoporosis, a health condition that weakens bones and makes them more likely to break.
Under ICD-10-CM, the term “Osteopenia” is indexed to ICD-10-CM subcategory M85. 8- Other specified disorders of bone density and structure, within the ICD-10-CM Alphabetic Index.
Group 1CodeDescription77080DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE)77085DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE), INCLUDING VERTEBRAL FRACTURE ASSESSMENT1 more row
A bone density scan is used to: Diagnose osteopenia (low bone mass) Diagnose osteoporosis. Predict risk of future fractures.
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.
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.
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).
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.
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:
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.
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.
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.
by Ken Camilleis, CPC, CPC-I, CMRS, CCS-P#N#Bone density studies measure specific mineral values in targeted bony structures throughout the skeletal system, which allows a physician to diagnose osteopor osis (porous bone) or osteopenia (low bone density, the precursor to osteoporosis).