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Oncology & Hematology Coding Alert

Reader Questions:

77080 and 77081 on Same Date Offers Challenge

Published on Mon Feb 07, 2011

Question: Our center provides DXA screenings for certain cancer patients. We've been getting denials from Medicare on those claims where we report both 77080 and 77081. Do we need to add a modifier to one of the codes?Answer: Whether you may report both studies together will depend on your payer. CMS has a mutually exclusive edit that places 77081 (Dual-energy X-ray absorptiometry [DXA], bone density study, 1 or more sites; appendicular skeleton [peripheral] [e.g., radius, wrist, heel]) in column 1 and 77080 (... axial skeleton [e.g., hips, pelvis, spine]) in column 2. This edit has a modifier indicator of 1.Chapter 9, section H.14, of the National Correct Coding Initiative Policy Manual states, "Although it may be medically reasonable and necessary to report both axial and peripheral bone density studies on the same date of service, NCCI edits prevent the reporting of multiple CPT codes for the axial bone density study [...]
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