medicare icd 10 code for screening dexa scan

Full Answer

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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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 right CPT code to use for a DEXA scan?

DEXA is basically short for dual energy X-ray absorptiometry. There is a standardized system of classification for following medical procedures and providing services, which is maintained through certain designated codes; in other words Current Procedural Terminology or CPT. The CPT code for dexa scans is 77080.

What are ICD-10 diagnostic codes?

ICD-10-CM Diagnosis Codes

A00.0	B99.9	1. Certain infectious and parasitic dise ...
C00.0	D49.9	2. Neoplasms (C00-D49)
D50.0	D89.9	3. Diseases of the blood and blood-formi ...
E00.0	E89.89	4. Endocrine, nutritional and metabolic ...
F01.50	F99	5. Mental, Behavioral and Neurodevelopme ...

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.

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.

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.

What is a FRAX assessment?

a. A FRAX Assessment is done to identify patients for BMD testing when any of the following criteria are met:

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.

What is a 77078/26 claim?

Claims for the professional component only (77078/26, 77080/26, 77081/26, and G0130/26) should indicate one of the following payable places of service for reimbursement : office (11), mobile (15), inpatient hospital (21), outpatient hospital (22), and independent clinic (49).

What is a dexa scan?

A dexa scan for a cancer patient is usually performed for staging purposes and is coded using the cancer diagnosis.

What happens if the payer does not pay for the screening?

If the payer does not pay for the screening then the patient should know this prior to the test. Findings during a screening are incidental to the expectation that the patient would be as healthy as they appear. Incidental findings are always secondary dx codes.

Can you code a diagnosis as the first listed?

You absolutely may not code the diagnosis as the first listed you must code screening first listed if the reason for the test was screening. The pate was asymptomatic if this was a screening and you cannot change the parameters of the reason for the test and "make the patient symptomatic" the findings were not expected and not wat was being investigated so the findings are incidental. I am sorry that the patient wil have to pay but they should have known that when they agreed to the screening.

Can you code a Dexa scan for osteopenia?

Click to expand... Yes. You can code it with osteopenia.

Is screening a DX code?

Sorry there is no confusion here, when the test is ordered as a screening then screening is the first listed dx code regardless of the findings. This per the coding guidelines which are HIPAA mandated to be followed. In addition you are changing the parameters of the test, the patient was asymptomatic upon presentation with no reason to believe there would be anything other than a clean result. If the payer does not pay for the screening then the patient should know this prior to the test. Findings during a screening are incidental to the expectation that the patient would be as healthy as they appear. Incidental findings are always secondary dx codes. Please do not assign dx codes just because it is the one that gets paid!

Can osteopenia be coded with osteopenia?

Yes. You can code it with osteopenia.

Can you add 733.90 to a primary diagnosis?

You may add 733.90 as a secondary diagnosis, but you cannot make it your primary diagnosis. "A screening code may be a first listed code if the reason for the visit is specifically the screening exam. It may also be used as an additional code if the screening is done during an office visit for other health problems.