Best Coding Guide for DEXA bone density scan CPT codes
Bone density CPT code 2015 (DEXA scan)
Bone density scan is performed to check the density of bones. We use to do bone density scan to check osteopenia (733.90, ICD10-M85.80) or osteoporosis (733.00, ICD10-M81.0) presence in bones. The amount of calcium correlates with bony content and with bone strength. The bone strength decreases with increase of age, hence the calcium content plays a key role in strengthening of bones.
Medical coders use ICD 10 code Z01.820, for Screening of bone density for osteoporosis. Osteopenia and osteoporosis both are caused because of low density in bone.Osteoporosis is generally more severe than osteopenia. Both are the most common diagnosis found during bone density exam coding. Moreover, we have very limited ICD 10 and CPT codes for coding DEXA scan. We will see later in this article, the CPT codes used for bone density exam and how they differ from each other.
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Importance of T and Z score in bone density and DEXA scan
Bone Mineral Density or called as BMD is very important to test regularly. The bones density decreases after a certain age, mostly after 55 or 60. Hence, it is important to go through DEXA scan which shows the true mass of your bone or skeleton. Men and Women who are between 55 to 65 ages, are recommended to go for BMD analysis periodically, to check for any risk of diseases like osteoporosis. DEXA is the best method which is painless and quick for BMD analysis.
T score shows the strength of bone compared with a young adult of the same gender with peak bone mass. As per the criteria of the World Health Organization, T score above -1 is considered normal, score between -1 and -2.5 is classified as Osteopenic and a T score below -2.5 is considered as Osteoporotic. T score is used to estimate your risk of developing a fracture.
Bone scan density CPT Code
Previous for coding DEXA scan, we use to have to major codes for coding Bone density procedure that is DEXA scan. Till 2014, we have used codes 77080 and 77081. Cpt code 77080 is used to code for bone density scan of axial bones like hip, pelvis and spine while 77081 was used to code axial bone like wrist, radius, heel etc. below is there detail description.
77080 Dual-energy X-ray absorptiometry (DEXA), bone density, 1 or more sites; axial skeleton (e.g., hips, pelvis, spine)
77081 Appendicular skeletons (peripheral) (e.g., radius, wrist, heel)
CPT code 77082 got deleted in 2015 for bone density scan. We are using cpt code 77086 in place of 77082. Lets check out these CPT codes.
There are two new codes have been introduced in 2015 for DEXA scan or bone density scan. These cpt codes will include the old codes and should never be coded with these codes. Below are the CPT codes used from 2015.
77085 Axial skeleton (e.g., hips, pelvis, spine), including vertebral fracture assessment
77086 Vertebral fracture assessment via dual-energy X-ray absorptiometry (DEXA)
Additionally, CPT code 77086 was created to report a vertebral fracture assessment via DEXA. Note, exclusionary language has been added in the CPT manual for instructions on how to appropriately bill for these two new codes.
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Do and Don’t for Bone density CPT Codes
Do not report 77080 in conjunction with 77085, 77086
Do not report 77085 cpt code in conjunction with 77080, 77086
Do not report 77086 cpt code in conjunction with 77080, 77085
While coding 77081 and 77080 together do remember to use modifier XU with cpt code 77080.