Billable Medical Code for Special Screening for Osteoporosis Diagnosis Code for Reimbursement Claim: ICD-9-CM V82.81. Code will be replaced by October 2015 and relabeled as ICD-10-CM V82.81. The Short Description Is: Screen – osteoporosis. Known As
Special screening for osteoporosis. Short description: Screen - osteoporosis. ICD-9-CM V82.81 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, …
Common diagnoses resulting from bone density studies may be reported with the following ICD-9-CM codes from Category 733 Other disorders of bone and cartilage: 733.0x Osteoporosis …
Oct 01, 2021 · 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 …
Code | Description |
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77080 | DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE) |
77085 | DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE), INCLUDING VERTEBRAL FRACTURE ASSESSMENT |
Common diagnoses resulting from bone density studies may be reported with the following ICD-9-CM codes from Category 733 Other disorders of bone and cartilage:#N#733.0x Osteoporosis#N#733.1x Pathologic fracture#N#733.9x Other and unspecified disorders of bone and cartilage#N#Bone pain and other bone disorders may be coded from Category 719 Other and unspecified disorders of joint; or#N#733.90 Disorder of bone and cartilage, unspecified.#N#Report personal or family history of bone disorders with:#N#V13.89 Personal history of other specified diseases;#N#V17.81 Family history of osteoporosis; or#N#V17.89 Family history of other musculoskeletal disease.#N#Example 1: A 59-year-old man presents to his primary care physician (PCP) with the chief complaint of creaking knees: His knees ache and pop every time he rises from his living room sofa. He also has heard and felt occasional snaps in his groin and shoulder blades. The PCP does a limited exam of these three regions and orders bilateral X-rays of these regions.#N#CPT® codes:
Quantitative ultrasound (QUS) – A portable machine used to measure bone density of the heel. Radiographic absorptiometry (RA) – This technique is most commonly used for bone density measurement at the hand or heel.
by Ken Camilleis, CPC, CPC-I, CMRS, CCS-P#N#Bone density studies measure specific mineral values in targeted bony structures throughout the skeletal system, which allows a physician to diagnose osteopor osis (porous bone) or osteopenia (low bone density, the precursor to osteoporosis).
You break a bone after age 50. You are a woman of menopausal age with risk factors. You are a postmenopausal woman under age 65 with risk factors. You are a man age 50-69 with risk factors. Or a physician might order a bone density study for a patient who has had: An X-ray showing a spinal break or bone loss. Back pain.
You are a woman of menopausal age with risk factors. You are a postmenopausal woman under age 65 with risk factors. You are a man age 50-69 with risk factors. Or a physician might order a bone density study for a patient who has had: An X-ray showing a spinal break or bone loss. Back pain.
Ken Camilleis, CPC, CPC-I, COSC, CMRS, CCS-P, is an educational consultant and PMCC instructor with Superbill Consulting Services, LLC. He is also a professional coder for Signature Healthcare, a health system covering much of southeastern Massachusetts. Camilleis’ primary coding specialty is orthopedics. Camilleis is a member of the Cape Coders local chapter in Hyannis, Mass.
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.
Osteoporosis. Osteoporosis is a disease that thins and weakens the bones. Your bones become fragile and break easily, especially the bones in the hip, spine, and wrist. In the United States, millions of people either already have osteoporosis or are at high risk due to low bone mass.
Also called: Screening tests. Screenings are tests that look for diseases before you have symptoms. Screening tests can find diseases early, when they're easier to treat. You can get some screenings in your doctor's office. Others need special equipment, so you may need to go to a different office or clinic.
In the United States, millions of people either already have osteoporosis or are at high risk due to low bone mass. Anyone can develop osteoporosis, but it is more common in older women. Risk factors include. Getting older.
Unacceptable principal diagnosis - There are selected codes that describe a circumstance which influences an individual's health status but not a current illness or injury, or codes that are not specific manifestations but may be due to an underlying cause.
Procedure code 77082 is considered by Medicare to represent vertebral fracture assessment only. Because code 77082 does not represent a BONE density study, when a BONE density study with vertebral fracture assessment is performed, bill the code for the appropriate BONE density study (e.g., 77080) plus code 77082.
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).
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.
BMM is covered when dual-energy x-ray absorptiometry is used to monitor osteoporosis drug therapy. Therefore, Medicare will pay procedure code 77080 when billed with the following ICD-9-CM diagnosis codes or any of the other valid ICD-9-CM diagnoses that are recognized by Medicare contractors appropriate for bone mass measurements:
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.
Priority Health will limit coverage for BMD studies to central DXA only. Any other BMD studies (e.g. peripheral, such as wrist, finger and heel) are not medically/clinically necessary and, therefore, not covered. BMD studies will not be prior authorized by Priority Health.
Medicare covers a bone mass measurement for a beneficiary once every two years (if at least 23 months have passed since the month the last bone measurement was performed). The criteria for bone mass measurement every two years are listed below: