what is the icd 10 code for bone density testing

by Tanya Durgan 6 min read

Disorder of bone density and structure, unspecified. M85.9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM M85.9 became effective on October 1, 2018.

ICD-10 code Z13. 820 for Encounter for screening for osteoporosis is a medical classification as listed by WHO under the range - Factors influencing health status and contact with health services .

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What are the common ICD 10 codes?

ICD-10-CM CODES (commonly used) These commonly used ICD-10 diagnosis codes are intended to assist physicians and other authorized ordering parties in providing correct ICD-10 codes as required by Medicare and other insurers. The codes are based on ICD-10-CM 2018, Medicare Regulations and Manuals authorized by the Centers for

Where can one find ICD 10 diagnosis codes?

Search the full ICD-10 catalog by:

  • Code
  • Code Descriptions
  • Clinical Terms or Synonyms

What ICD10 code will Medicare pay for a bone density?

The codes that describe bone biopsies may be used for indications including a bone density evaluation. When a bone biopsy is used for bone density measurement, the covered indications ... ICD-10 CM code Z90.721 or Z90.722 should be reported for women s/p oophorectomy. ICD-10 ... Medicare will not pay BMM claims for single photon absorptiometry ...

What is the diagnosis code for bone density?

The ICD-10 code range for ICD-10 Disorders of bone density and structure M80-M85 is medical classification list by the World Health Organization (WHO).

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What diagnosis codes cover bone density?

DEXA scan CPT code 77080 & 77081; Bone Density coding.

What ICD-10 codes cover a DEXA scan?

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.

What is the ICD-10 code for screening for osteoporosis?

Z13. 820 Encounter for screening for osteoporosis - ICD-10-CM Diagnosis Codes.

What is the CPT code for a bone density test?

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.

What diagnosis can be used for DEXA scan?

DXA is most often used to diagnose osteoporosis, a condition that often affects women after menopause but may also be found in men and rarely in children. Osteoporosis involves a gradual loss of bone, as well as structural changes, causing the bones to become thinner, more fragile and more likely to break.

What is the procedure code for a bone scan?

CPT® 78306, Under Diagnostic Nuclear Medicine Procedures on the Musculoskeletal System.

Is a bone density test considered diagnostic?

A bone density scan is used to: Diagnose osteopenia (low bone mass) Diagnose osteoporosis. Predict risk of future fractures.

Does Medicare cover a screening bone density test?

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.

How often can you have a DEXA scan on Medicare?

Yes, bone mass measurement scans are covered once every 24 months by Medicare Part B if you meet one or more of the following criteria: You're a woman whose doctor determines you are estrogen deficient and are at risk for osteoporosis.

How do you bill for a DEXA scan?

Billing CPT 77080, 77081, 77082 with covered dxREIMBURSEMENT CODES FOR BONE DENSITOMETRY.CPT Code 77080 – Hip, spine or central DEXA (Dual Energy X-Ray Absorptiometry) studies. ... CPT Code 77081 – Peripheral DEXA Bone Mineral Density – $27.72.CPT Code 77082 – Peripheral Ultrasound Bone Mineral Density.Indications for DEXA.

What is the ICD-10 for osteopenia?

9: Disorder of bone density and structure, unspecified.

Is bone density same as DEXA scan?

A bone density scan uses low dose X-rays to see how dense (or strong) your bones are. You may also hear it called a DEXA scan. Bone density scans are often used to diagnose or assess your risk of osteoporosis, a health condition that weakens bones and makes them more likely to break.

Does Medicare cover DEXA screening?

Does Medicare Cover DEXA Scans? In most cases, Medicare insurance does cover DEXA scans under Part B. Medicare Part B (Medical Insurance) provides benefits for outpatient procedures that are deemed medically necessary for ongoing treatment of illness.

Does Medicare cover a screening bone density test?

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.

What is the ICD 10 code for postmenopausal osteoporosis?

M85. 8 Other specified disorders of bone density and structure.

Does Medicare cover bone density for males?

Nationally, Medicare currently provides coverage for DXA scans in men when an individual has been previously diagnosed with osteoporosis, primary hyperparathyroidism, vertebral bone fracture, or osteopenia of the spine, or in certain other situations.

When will the ICD-10 Z13.820 be released?

The 2022 edition of ICD-10-CM Z13.820 became effective on October 1, 2021.

What is screening for asymptomatic individuals?

Screening is the testing for disease or disease precursors in asymptomatic individuals so that early detection and treatment can be provided for those who test positive for the disease. Type 1 Excludes. encounter for diagnostic examination-code to sign or symptom. Encounter for screening for other diseases and disorders.

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.

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 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.

Why do you need to measure BMD?

An initial measurement of BMD at the hip or spine may be considered medically necessary to assess fracture risk and the need for pharmacologic therapy in both women and men who are considered at risk for osteoporosis. BMD testing may be indicated under the following conditions:

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).

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.

Is BMD prior authorization?

BMD studies will not be prior authorized by Priority Health.

What is the ICd 9 code for bone density?

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:

How to measure bone density?

The most common, accurate method to measure bone density involves dual energy X-ray absorptiometry (DXA). DXA projects two X-ray beams to better assess bone density and can detect a variance as small as 3 percent from one scan to the next. Conventional X-rays are not sensitive enough to detect such small variances. DXA is especially effective for full-body skeletal assessments, as well as for focused studies of the hip, spinal column, and forearm (the skeletal areas most likely to break).#N#During a DXA scan, the patient rests on a cushioned platform. Mechanical arms are placed under the X-ray table and are aligned with an X-ray detector placed above the patient’s body. The amount of X-ray energy absorbed by the bone is measured to determine the strength of that bone. Less energy will pass through healthy bone than through osteopenic or osteoporotic bone.#N#Aside from using DXA, a bone density study might be conducted using:

What is the DXA used for?

Aside from using DXA, a bone density study might be conducted using: Peripheral DXA (pDXA) – Portable machines used to measure bone density in the arms or legs.

Why is age important for osteoporosis?

Age is a key factor because the older a person gets, the more bone he or she tends to lose (reflected in ICD-9-CM classification as “Senile,” and in ICD-10-CM as “Age-related”). Gender is also a factor. Women are more prone to osteoporosis because they have smaller bones than men.

What is the best method to measure bone density?

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.

What is a Z score for osteoporosis?

According to WHO guidelines, a Z-score less than -1.5 is a red flag for further workup to diagnose or rule out secondary osteoporosis. The lower the Z-score, the more likely another factor besides the normal aging process is the cause of premature bone loss.

What age do you break a bone?

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.

When is CPT code 0508T effective?

This revision is effective for claims processed on or after April 2, 2019 for dates of service on or after July 1, 2018.

Is CDT a trademark?

These materials contain Current Dental Terminology (CDT TM ), copyright © 2020 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

Is CPT a year 2000?

CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon no upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

Does CMS have a CDT license?

Organizations who contract with CMS acknowledge that they may have a commercial CDT license with the ADA, and that use of CDT codes as permitted herein for the administration of CMS programs does not extend to any other programs or services the organization may administer and royalties dues for the use of the CDT codes are governed by their commercial license.

What is part B of bone mass?

Bone mass measurements. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. You’re a woman whose doctor determines you’re estrogen deficient and at risk for osteoporosis, based on your medical history and other findings.

What type of fractures can be seen on X-rays?

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.

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