Your doctor is likely to ask you questions, such as:
What You Need to Know About Osteopenia
The bones that make up your spine (vertebrae) can weaken to the point that they crumple and collapse, which may result in back pain, lost height and a hunched posture. Bone fractures, particularly in the spine or hip, are the most serious complications of osteoporosis.
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.
M85. 89 - Other specified disorders of bone density and structure, multiple sites | ICD-10-CM.
ICD-10 Code for Disorder of bone density and structure, unspecified- M85. 9- Codify by AAPC.
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.
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.
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
If you have a lower than normal bone density score — between -1 and -2.5 — you have osteopenia. If you score is lower than -2.5, you may be diagnosed with osteoporosis. Osteoporosis is the more serious progression of osteopenia.
For example, Z12. 31 (Encounter for screening mammogram for malignant neoplasm of breast) is the correct code to use when you are ordering a routine mammogram for a patient.
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.
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.
Osteopenia is the beginning stages of osteoporosis. The report stated that there was no osteoporosis present, so that would not be coded, only osteopenia. If you look up osteoporosis there is no "Excludes 1,2" for osteopenia.
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.
The Centers for Medicare & Medicaid Services (CMS) will implement Change Request (CR) 9252 on January 4, 2016, effective October 1, 2015. (See related MLN Matters® article MM9252.) This CR establishes the list of covered conditions and corresponding ICD-10-CM diagnosis codes approved for Bone Mass Measurement studies according to the requirements set forth in National Coverage Determination (NCD) 150.3. CR9252 and accompanying spreadsheet inadvertently omitted the condition of osteopenia and the ICD- 10-CM codes that describe it which are classified to subcategory M85.8- Other specified disorders of bone density and structure. The codes and conditions identified within this subcategory are considered covered indications for bone mass measurement under NCD 150.3 and providers should report these appropriately according to medical documentation. Additional guidance and education as to the updated complete list of covered indications will be forthcoming as CMS continues to review this issue and the systems updates required.
Under ICD-9-CM, the term “Osteopenia” was indexed to ICD-9-CM diagnosis code 733.90 (Disorder of bone and cartilage). This code was listed as a covered condition under the Business requirement 5521.1.1 for CR 5521/NCD 150.3, dated May 11, 2007, when reported with CPT code 77080. (See related MLN Matters article MM5521.) The accompanying Benefit Policy Manual, Publication 100-02, chapter 15, section 80.5.6, Beneficiaries Who May Be Covered, includes: 2. An individual with vertebral abnormalities as demonstrated by an x-ray to be indicative of osteoporosis, osteopenia, or vertebral fracture.
Answer. • The ICD-10 codes that crosswalk with Osteopenia are under subcategory M85.8 and do not refer to Osteopenia. They are a group of very nonspecific disorders of bone density which do NOT justify or qualify for Vitamin D testing. • The specificity of the ICD-10 testing has refined what disorders qualify for coverage ...
ICD-10-CM Z09 should be reported for an individual who has COMPLETED drug therapy for osteoporosis and is being monitored for response to the therapy.
o An individual with vertebral abnormalities as demonstrated by an x-ray to be indicative of osteoporosis, osteopenia (low bone mass), or vertebral fracture
ICD-10-CM code Z79.51 or Z79.52 should be reported for an individual on glucocorticoid therapy.
Medicare will cover a confirmatory baseline bone mass measurement when it is performed with a dual energy x-ray absorptionmetry system (axial skeletal) to permit monitoring of beneficiaries in the future, if the initial test was performed with a technique that is different from the proposed monitoring method (for example, if the initial test was bone sonometry and the patient will be monitored with bone densitometry, a second test utilizing densitometry will be paid). If the initial bone mass measurement was performed by a dual-energy x-ray absorptionmetry system (axial skeletal), a confirmatory BMM is not covered.
code to identify severity of ulcer ( L97.-)
code to specify type of infection, such as:; cellulitis of abdominal wall (L03.311); sepsis (A40.-, A41.-)
Varicose veins of lower extremities w ulc and inflammation; code to identify severity of ulcer (L97.-)
K50.01 Crohn's disease of small intestine with compl...