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.
Medicare will always deny Z13. 820 if it is the primary or only diagnosis code.
According to a Medicare National Coverage Determinations Coding Policy Manual and Change Report (ICD-10-CM), Z13. 820 Encounter for screening for osteoporosis is not covered by Medicare for a diagnostic lab testing service.
Z13. 820 - Encounter for screening for osteoporosis. ICD-10-CM. Centers for Medicare and Medicaid Services and the National Center for Health Statistics; 2018.
Medicare will cover a test once every 24 months for a preventive screening if they meet the following requirements: a doctor certifies a woman is at risk for osteoporosis due to estrogen deficiency or medical history. a person's X-ray shows signs of osteoporosis, osteopenia, or fractured vertebrae.
Medicare coverage Your X-rays show possible osteoporosis, osteopenia, or vertebral fractures. You're taking prednisone or steroid-type drugs or are planning to begin this treatment. You've been diagnosed with primary hyperparathyroidism. You're being monitored to see if your osteoporosis drug therapy is working.
The full cost of a bone density scan is covered under original Medicare every 24 months. If you need to have a bone density test more often, your doctor will have to provide proof of a reason for more frequent testing.
Original Medicare and Medicare Advantage generally cover bone density testing and other bone mass measurements once every 24 months.
Preventive care is recommended to ensure you stay healthy. Bone density tests or bone mass measurements are a type of preventive care doctors often recommend to diagnose osteoporosis.
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.
CPT® Coding for Bone Density Studies A bone density measurement and interpretation by ultrasound is reported with CPT® 76977 Ultrasound bone density measurement and interpretation, peripheral site(s), any method.
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.)
Z13.820 is a billable diagnosis code used to specify a medical diagnosis of encounter for screening for osteoporosis. The code Z13.820 is valid during the fiscal year 2021 from October 01, 2020 through September 30, 2021 for the submission of HIPAA-covered transactions. The code is exempt from present on admission (POA) reporting for inpatient admissions to general acute care hospitals.#N#The code Z13.820 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis.
Z13.820 is exempt from POA reporting - The Present on Admission (POA) indicator is used for diagnosis codes included in claims involving inpatient admissions to general acute care hospitals. POA indicators must be reported to CMS on each claim to facilitate the grouping of diagnoses codes into the proper Diagnostic Related Groups (DRG). CMS publishes a listing of specific diagnosis codes that are exempt from the POA reporting requirement. Review other POA exempt codes here.
The ICD-10-CM Alphabetical Index links the below-listed medical terms to the ICD code Z13.820. Click on any term below to browse the alphabetical index.
This is the official exact match mapping between ICD9 and ICD10, as provided by the General Equivalency mapping crosswalk. This means that in all cases where the ICD9 code V82.81 was previously used, Z13.820 is the appropriate modern ICD10 code.