icd 10 code for preventative dexa bone scan

ICD-10 CM code Z90.721 or Z90.722 should be reported for women s/p oophorectomy. ICD-10 CM code Z79.51, Z79.52 should be reported for an individual on glucocorticoid therapy. 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.

Full Answer

Is DEXA scan the only measure of bone health?

Testing your bone density -- how strong your bones are -- is the only way to know for sure if you have osteoporosis. The most widely used is a scan called dual energy X-ray absorptiometry (DXA or DEXA). The test determines bone health and your risk of fracture due to osteoporosis. DXA scanning focuses on two main areas -- the hip and the spine.

Is DEXA scan and bone scan same thing?

DEXA measures the mineral content of the bones, while a bone scan helps to diagnose different bone conditions. These are different in terms of purpose, assessment, and application. DEXA Scan NJ has gained a lot of attention in recent years.

How often do I need a DEXA scan?

• One T-score unit (e.g. ...
• Once you are a few years beyond the age of menopause, assuming you are generally healthy, your expected bone loss is 0.5% per year or 5% in 10 years.
• 5% loss is -0.5 T-score; thus, you can expect to drop one-half a T-score every 10 years.

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What is the CPT code for DEXA scan?

DEXA CPT CODE 77080, 77081 – Description and Guidelines. Limitations: 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).

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.

How do you bill for a DEXA scan?

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.

What is the ICD-10 code for osteoporosis screening?

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

What diagnosis can be used for DEXA scan?

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.

What ICD-10 code covers bone 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.

What diagnosis codes cover bone density?

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

What is the ICD-10 code for bone density?

ICD-10 Code for Disorder of bone density and structure, unspecified- M85. 9- Codify by AAPC.

What is the CPT code for DEXA scan?

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

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 is the difference between a DEXA scan and a bone density test?

A bone density test, also referred to as a DEXA scan, is a noninvasive test that measures calcium and other minerals in your bones. It measures the strength and thickness, or mass, of your bones. As we age, bones naturally become thinner. Osteopenia occurs when bones are thinner than normal.

How do I get Medicare to cover my DEXA scan?

To make sure you meet the criteria to have your bone density test fully covered by Medicare, you doctor needs to provide documentation that you meet one of the following conditions: You require the test for a medical reason, such as high risk for osteoporosis, osteopenia, sudden pain, or an injury.

What is the CPT code for osteoporosis screening?

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.

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.

What is a vertebral fracture?

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.

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.

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).

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 First Coast Billing and Coding Article for Local Coverage Determination (LCD) L36356 Bone Mineral Density Studies provides billing and coding guidance for frequency limitations as well as diagnosis limitations that support diagnosis to procedure code automated denials.

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.

Where is bone density measured?

Bone density can be measured at the wrist, spine, hip, or calcaneus (heel). Single and combined measurements may be required to diagnose bone disease, monitor bone changes with disease progression, or monitor bone changes with therapy. Coverage. Medicare provides coverage for the following densitometers:

What is a bone densitometer?

Is performed with a bone densitometer (other than dual photon absorpti ometry) or a bone sonometer (e.g., ultrasound) device approved or cleared for marketing by the FDA; Is performed for the purpose of identifying bone mass, detecting bone loss, or determining bone quality; and. Includes a physician's interpretation of the procedure's results.

What is bone mass measurement?

"Bone mass measurement," also known as "bone density study," is a radiological or radioisotope procedure or other procedure approved by the Food and Drug Administration (FDA). It identifies bone mass, detects bone loss, or determines bone quality. Bone mass measurements evaluate bone disease and/or responses of treatment;

Who must provide an order for a bone mass test?

The physician or qualified non-physician practitioner treating the qualified individual must provide an order for a bone mass measurement test, following an evaluation of the need for a bone mass measurement that included a determination of the medically appropriate measurement for the individual.

Does Medicare cover bone mass?

Medicare's bone mass measurement benefit includes a physician's interpretation of the procedure's results .Medicare provides coverage of bone mass measurements that meet coverage criteria 1-6 below: The bone mass measurement is performed on a qualified individual.

What are the risk factors for DXA?

With any one of these factors, your insurance company should cover a DXA. 1) Early menopause (before age 40) 2) Adults with a prior low-impact fracture. 3) Adults with a disease or condition ...

Does Medicare cover bone density?

Medicare coverage. 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. Many insurance providers will cover the test under certain circumstances.