The condition is osteopenia, or low bone density. Many doctors consider it to be a first step toward osteoporosis, a serious disorder that leaves bone density extremely low and makes bones porous and prone to shatter.
What You Need to Know About Osteopenia
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.
Age-related osteoporosis without current pathological fracture. M81.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
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.
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.
M85.89Question: What is the correct ICD-10 for osteopenia in the hips and spine? Answer: Code M85. 89 (Other specified disorders of bone density and structure, multiple sites).
Disorder of bone density and structure, unspecified The 2022 edition of ICD-10-CM M85. 9 became effective on October 1, 2021.
(OS-tee-oh-PEE-nee-uh) A condition in which there is a lower-than-normal bone mass or bone mineral density (the amount of bone mineral contained in a certain amount of bone). Osteopenia is a less severe form of bone loss than osteoporosis.
Some things can make bone loss happen more quickly, leading to osteopenia, such as: Medical conditions such as hyperthyroidism. Medications such as prednisone and some treatments for cancer, heartburn, high blood pressure and seizures. Hormonal changes during menopause.
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.
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.
M85. 88 - Other specified disorders of bone density and structure, other site | ICD-10-CM.
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.
851.
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.
Z13. 820 Encounter for screening for osteoporosis - ICD-10-CM Diagnosis Codes.
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
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.
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.
The 2022 edition of ICD-10-CM M81.0 became effective on October 1, 2021.
A disorder characterized by reduced bone mass, with a decrease in cortical thickness and in the number and size of the trabeculae of cancellous bone ( but normal chemical composition), resulting in increased fracture incidence.
A condition of reduced bone mass, with decreased cortical thickness and a decrease in the number and size of the trabeculae of cancellous bone (but normal chemical composition), resulting in increased fracture incidence. Osteoporosis is classified as primary (type 1, postmenopausal osteoporosis; type 2, age-associated osteoporosis; and idiopathic, which can affect juveniles, premenopausal women, and middle-aged men) and secondary osteoporosis (which results from an identifiable cause of bone mass loss).
Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis (osteoporosis, postmenopausal) and age-related or senile osteoporosis.
Loss of bone mass and strength due to nutritional, metabolic, or other factors, usually resulting in deformity or fracture; a major public health problem of the elderly, especially women. Metabolic disorder associated with fractures of the femoral neck, vertebrae, and distal forearm.
It occurs commonly in women within 15-20 years after menopause, and is caused by factors associated with menopause including estrogen deficiency. Osteoporosis makes your bones weak and more likely to break. Anyone can develop osteoporosis, but it is common in older women.
Osteoporosis is classified as primary (type 1, postmenopausal osteoporosis; type 2, age-associated osteoporosis; and idiopathic, which can affect juveniles, premenopausal women, and middle-aged men) and secondary osteoporosis (which results from an identifiable cause of bone mass loss).
Medicare also lists M89.9 as an approved code for osteopenia, when would it be appropriate to use M89.9 "disorder of bone, unspecified"?
Regarding the coverage for breast cancer patients, if the provider or report says menopausal state or post-menopause then you can use Z78.0 which meets medical necessity for 77080 per LCD policy.
M85.8XX is correct for Osteopenia because the index points to that code range
The 2022 edition of ICD-10-CM M81.8 became effective on October 1, 2021.
In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere.". Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code.