icd-10 code for dexa scan for medicare 2021

Full Answer

What diagnosis will Medicare cover for a DEXA scan?

Medicare Part B* (Medical Insurance) covers bone density test (DXA) as part of preventive screening once every 24 months (or more often if medically necessary) if you meet one or more of these conditions: You’re a woman whose doctor determines you’re estrogen deficient and at risk for osteoporosis, based on your medical history and other findings.

What is 77080 CPT code?

Effective for dates of service on or after January 1, 2007, Medicare will pay for BMM services for dual-energy x-ray absorptiometry (CPT code 77080) when this procedure is used to monitor osteoporosis drug therapy. In addition, new CPTs were assigned to BMMs.

Does Medicare pay for screening DEXA scan?

Medicare will pay for a bone density test (DXA) as part of preventive screening every two years for women 65 or older and men 70 or older. How Much Does Medicare pay for bone density test? If you qualify, Original Medicare covers bone mass measurements at 100% of the Medicare -approved amount when you receive the service from a participating provider.

What is the CPT code for bone density scan?

The CPT Code 77078 is the code used for Radiology / bone/joint studies. The general guidance for this code is that it is used for ct scan bone mineral density study 1 or more sites.

What ICD-10 will Medicare cover for DEXA scan?

Many ICD-10 codes cover fractures, but there are other ICD-10 codes Medicare will cover when used with a DXA Bone Scan (77080): 0 // Asymptomatic menopausal state. 3 // Long term (current) use of hormonal contraceptives.

What diagnosis covers DEXA scan for Medicare?

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.

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. When 77078, 77080, 77081, 77085, 76977 or G0130 is done as an initial diagnostic test that determines a diagnosis of E24.

What is the ICD 10 code for bone density scan?

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.

How do you code a DEXA scan?

77085: Dual-energy X-ray absorptiometry (DEXA), bone density study, one or more sites; axial skeleton (e.g., hips, pelvis, spine), including vertebral fracture assessment.

What is the ICD 10 code for osteoporosis screening?

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

Is a DEXA scan a bone scan?

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.

What diagnosis covers a bone density?

Types of Bone Density Tests DXA (dual-energy X-ray absorptiometry) measures the spine, hip, or total body. Doctors consider this test the most useful and reliable for checking bone density. QCT (quantitative computed tomography) usually measures the spine, but it can test other sites, too.

Who must maintain a copy of the test results and interpretation?

If the provider of the service is other than the ordering/referring physician/nonphysician practitioner, that provider must maintain a copy of test results and interpretation, along with copies of the ordering/referring physician/nonphysician practitioner’s order for the studies. The clinical indication/medical necessity for the study must be indicated in the order for the test.

Can Medicare bill for non-covered services?

Notice:It is not appropriate to bill Medicare for services that are not covered (as described by this entire LCD) as if they are covered. When billing for non-covered services, use the appropriate modifier.

When will the ICD-10 Z13.820 be released?

The 2022 edition of ICD-10-CM Z13.820 became effective on October 1, 2021.

What is screening for asymptomatic individuals?

Screening is the testing for disease or disease precursors in asymptomatic individuals so that early detection and treatment can be provided for those who test positive for the disease. Type 1 Excludes. encounter for diagnostic examination-code to sign or symptom. Encounter for screening for other diseases and disorders.

Medicare Coverage Of Osteoporosis Medications

Many medications available today can slow the rate of bone loss and, in some cases, even rebuild bone strength.

Who Should Undergo A Bone Density Test

Postmenopausal women, men ages 70 and older, or those who recently suffered from a broken bone are advised to take a bone density test. Women are at high risk for osteoporosis. Bone loss is women is fastest during the first few years after menopause and continues into old age.

Osteoporosis And Its Complications

Osteoporosis is a medical condition characterized by architectural weakening in the bones and decreased bone mass. These changes make the bones more fragile and increase the risk of fractures, especially at the spine, hip, and wrist.

Risk Factors For Osteoporosis

When you think of osteoporosis, you likely think of women. It is true that postmenopausal women are at highest risk for the condition. Once their bodies no longer produce premenopausal levels of estrogen, the protective benefits of the hormone on their bones go away.

Does Medicare Cover Bone Density Testing

Fortunately, Medicare feels that bone health is essential and can help you get excellent bone care, whether it be testing or treatment. There are about 10 million people in the United States alone with Osteoporosis and almost 34 million more with low bone mass.

How Is Bone Density Testing Done

Bone density testing is typically done in a clinical setting such as a hospital or an outpatient facility. After putting on a loose gown, youll be asked to lie on a padded platform. A suspended mechanical arm then passes over parts of your body, taking images of your skeleton.

How To Get Help Covering The Cost Of Bone Density Testing Under Medicare

Supplemental plans fill in the gaps by covering the 20% you would otherwise pay under Part B. By relieving you of this cost, you can worry less about bills and more about recovery. The best part about a supplement is that when Medicare approves a service, the supplement must authorize the service as well.

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 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.

How to measure BMD?

DXA is probably the most commonly used technique to measure BMD because of its ease of use, low radiation exposure, and its ability to measure BMD at both the hip and spine. 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. The low energy beam is preferentially attenuated by bone, while the high energy beam is attenuated by both bone and soft tissue. This differential attenuation between the 2 beams allows for correction for the irregular masses of soft tissue, which surround the spine and hip, and therefore the measurement of bone density at those sites.

When did Medicare pay for BMM?

Effective for dates of service on or after January 1, 2007, Medicare will pay for BMM services for dual-energy x-ray absorptiometry (Procedure code 77080) when this procedure is used to monitor osteoporosis drug therapy. New Procedure codes have also been assigned to BMMs.

What is the ICd 9 code for osteopenia?

ICD-9-CM code 733.90 should be reported to indicate osteopenia, (only when billing 77080-DXA), when used to follow treatment with FDA approved osteoporosis medications.

Is CPT 77085 billed for screening?

CPT 77085 should NOT be billed for screening and is not part of the Preventive Benefit. Member cost share will apply when medically necessary criteria are met.

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).