icd 10 code for boniva

Full Answer

What is the ICD 10 diagnosis code for Prolia?

In addition, ICD-10-CM diagnosis code range T38.0X5A - T38.0X5S was added to the “ICD-10 Codes that Support Medical Necessity” section of the LCD under “Group 1 Codes:” for HCPCS code J0897 (Prolia®). Also, the “Sources of Information” section of the LCD was updated.

What is Boniva®?

Boniva® is a bisphosphonate that inhibits osteoclast activity and reduces bone resorption and turnover, leading to, on average, a net gain in bone mass. Boniva® is available in oral and IV forms.

What is the ICD 10 code for Xgeva?

Explanation of Revision: Based on an external correspondence and LCD reconsideration, this LCD was revised to add ICD-10-CM codes C90.00, C90.01, C90.02 and M84.50XA – M84.58XS to the “ICD-10 Codes that Support Medical Necessity” section of the LCD under “Group 4 Codes:” for HCPCS code J0897 (Xgeva®).

What is BONIVA for osteoporosis?

BONIVA is a prescription medicine used to treat or prevent osteoporosis in women after menopause. BONIVA helps increase bone mass and helps reduce the chance of having a spinal fracture (break). It is not known how long BONIVA works for the treatment and prevention of osteoporosis.

What ICD-10 code covers bone density for Medicare?

(L34639) Bone Mass Measurement ICD-10 Codes That Support Medical Necessity and Covered by Medicare Program: Group 1 Paragraph: Note: ICD-10 codes must be coded to the highest level of specificity.

What ICD-10 code covers DEXA scan for Medicare 2022?

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.

What classification is BONIVA?

Boniva belongs to a class of drugs called bisphosphonates.

What is the ICD-10 code for screening for osteoporosis?

Z13. 820 Encounter for screening for osteoporosis - ICD-10-CM Diagnosis Codes.

What diagnosis 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.

What is 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.

What diagnosis covers DEXA scan for Medicare?

osteoporosisMedicare 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.

How do you code a DEXA scan?

CPT® Coding for Bone Density Studies 77081 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel).

What is the generic name for Boniva?

Boniva, known by the generic name ibandronate, is a once-a-month pill prescribed to prevent or to treat bone loss from osteoporosis. The FDA officially approves Boniva only for treatment of postmenopausal women, as the clinical studies that led to approval mostly enrolled women.

Is Boniva the same as Fosamax?

Are Boniva and Fosamax the same? Boniva and Fosamax are second-generation bisphosphonates, but they are not exactly the same. Their biggest difference is in how they are dosed. Boniva can be given once monthly, while Fosamax can be given once daily or once weekly.

Why was Boniva taken off the market?

There are concerns about the long-term safety of bisphosphonates (such as Boniva) as long-term use has been associated with atypical femur fractures, osteonecrosis of the jaw, and esophageal cancer.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Article Guidance

This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L33270 Bisphosphonates (Intravenous [IV]) and Monoclonal Antibodies in the Treatment of Osteoporosis and Their Other Indications. Please refer to the LCD for reasonable and necessary requirements.

ICD-10-CM Codes that Support Medical Necessity

It is the provider’s responsibility to select codes carried out to the highest level of specificity and selected from the ICD-10-CM code book appropriate to the year in which the service is rendered for the claim (s) submitted.

ICD-10-CM Codes that DO NOT Support Medical Necessity

All those not listed under the “ICD-10 Codes that Support Medical Necessity” section of this article.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

Document Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

CMS National Coverage Policy

This LCD supplements but does not replace, modify or supersede existing Medicare applicable National Coverage Determinations (NCDs) or payment policy rules and regulations for Bisphosphonates (Intravenous [IV]) and Monoclonal Antibodies in the Treatment of Osteoporosis and Their Other Indications.

Coverage Guidance

This LCD addresses “incident to” drugs that are not self-administered for certain patients with osteoporosis. The other indications for these drugs are also addressed.

Drug Information

The labeler code, product code, and package code segments of the National Drug Code number, separated by hyphens. Asterisks are no longer used or included within the product and package code segments to indicate certain configurations of the NDC.

Route & Dosage

The translation of the DosageForm Code submitted by the firm. The complete list of codes and translations can be found www.fda.gov/edrls under Structured Product Labeling Resources.

Drug Package Information

The labeler code, product code, and package code segments of the National Drug Code number, separated by hyphens. Asterisks are no longer used or included within the product and package code segments to indicate certain configurations of the NDC.

Product Application & Marketing Information

The labeler code and product code segments of the National Drug Code number, separated by a hyphen. Asterisks are no longer used or included within the product code segment to indicate certain configurations of the NDC.