Ob-Gyn Coding Alert

Question: If a patient has had DEXA exams for years and our ob-gyn treated her for osteopenia, is this still considered a routine screening test? My colleague billed it with an osteopenia diagnosis and the payer applied this visit to the deductible. The patient says the DEXA scan is a screening exam and covered 100 percent. Does the DEXA scan qualify as a screening exam? Tennessee Subscriber Answer: If the reason the ob-gyn performed the DEXA scan (77080, Dual-energy X-ray absorptiometry [DXA], bone density study, 1 or more sites; axial skeleton [e.g., hips, pelvis, spine]) was because the patient had a previous DEXA that showed osteopenia, it is not a screening exam. However, if the ob-gyn ordered it before a diagnosis was made and the result shows osteopenia (733.90, Disorder of bone and cartilage, unspecified), then this is still a screening exam and the screening diagnosis (V82.81, Special screening for [...]