Primary Care Coding Alert

Question: At our clinic, x-ray technicians perform DXA scans and the family physicians interpret the findings. Is there a code for in-house physician interpretation of these findings?


West Virginia Subscriber


Answer: No. CPT does not contain a separate code for physician interpretation of dual energy x-ray absorptiometry (DXA) scans or bone density studies. No separate code exists because the bone density study codes already include individual components that can describe the professional and technical portions of this service.

Here's how: To code for only the physician component of a DXA scan, you should use modifier 26 (Professional component) on the study code, such as 76075 (Dual energy x-ray absorptiometry [DXA], bone density study, one or more sites; axial skeleton [e.g., hips, pelvis, spine]) and 76076 (- appendicular skeleton [peripheral] [e.g., radius, wrist, heel]).

If you were instead billing for the technical component, you would attach modifier TC to 76075-76076. When the physician owns the equipment (technical portion) and interprets the DXA scans (professional portion), you should assign the global code, meaning 76075-76076 without modifier 26 or TC.

Be careful: Make sure the x-ray technicians are not using the global DXA scan code. If you are reporting the professional component and the x-ray coder is billing for the complete DXA scan service, you will be double- dipping on the professional portion of the study. Work with the x-ray coder to determine whether you should each bill for the DXA scan's individual portions.

Also, if the FP's interpretation is really a confirmation and reread of the DXA scan--and the technician actually issues the written report--you should instead include the physician's work in the medical decision-making portion of the office visit or other E/M service. For instance: When the patient returns for a face-to-face encounter in which the physician explains where she stands and how she compares to the -ideal- 30-year-old woman (T score) and also to other women her own age (Z score), you should use 99212-99214 (Office or other outpatient visit for the evaluation and management of an established patient -).