Basics about CPT code for DEXA scan

DEXA stands for Dual energy X-ray absorptiometry. DEXA scan is done to evaluate the density of the bone. This test is done specially to screening test for osteoporosis. Osteoporosis is caused when there is significant decrease in the density of the bone. The CPT code for DEXA scan is divided on the basis of the bones studied during the exam. The codes for appendicular and axial skeleton have different CPT code for DEXA scan. Dual energy x-ray absorptiometry (DEXA) is a two-dimensional projection system that involves two x-ray beams with different levels of energy being pulsed alternately. So, we have two most common CPT code for DEXA scan

77080 – DEXA scan for axial skeleton 1 or more sites (hips, pelvis, and spine)

77081 – DEXA scan for appendicular skeleton 1 or more sites (peripheral) (radius, wrist, and heel)

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Indications for CPT code DEXA scan

Patient will have to under DEXA scan when they are have vertebral abnormalities. Also, when there’s deficiency of estrogen or ovarian disease or failure. Hyperparathyroidism also may lead the physician to perform DEXA scan. Signs and symptoms related to bone mostly undergo DEXA scan to find any diagnosis with the density of bone like osteopenia or osteoporosis.

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Diagnosis used with CPT code for DEXA scan

The most common diagnosis used with DEXA scan for osteopenia 733.90 and osteoporosis 733.00. If no diagnosis is present we are allowed to use Screening code for Osteoporosis V82.81. Also we have Postmenopausal status code V49.81 used while coding CPT code for DEXA scan. There is a combined code for postmenopausal and osteoporosis called as Senile Osteoporosis 733.01. Don’t code separately when postmenopausal and osteoporosis when both are present along with CPT code for DEXA scan.

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ICD 10- codes

Osteopenia (733.90)

M89.9- Disorder of bone, unspecified

M94.9- Disorder of cartilage, unspecified

Osteoporosis (733.00)

M81.0 -Age-related osteoporosis without current pathological fracture

Senile Osteoporosis (733.01)

M81.0 -Age-related osteoporosis without current pathological fracture

Screening for osteoporosis (V82.81)

Z13.820 Encounter for screening for Osteoporosis

Postmenopausal status (V49.81)

Z78.0 Asymptomatic menopausal state

CCI edit with CPT code for DEXA scan

When both 77080 and 77081 are performed on same day we have to use modifier to bypass the CCI edits. As per the edits we have to append 59 modifier with CPT code 77080 to bill both the procedure (77080-59). Both the procedures are paid only with proper use of 59 modifier, if missed these procedure will not paid.

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