Radiology Coding Alert

Question: Our physician performed an X-Ray for a child to determine age. The medical necessity for the procedure has been documented as ‘age determination.’ How can we report an X-Ray that is done solely for the purpose of ascertaining the age of a child?

New York Subscriber

Answer: Your physician is performing the X-Ray to determine the bone age or skeleton age. You submit code 77072 (Bone age studies) for this service.

Bone age: Bone age is an indicator of the skeletal and biological maturity of an individual. Bone age is a better parameter than the chronological age calculated from the date of birth. Bone age assessments may be done when birth records are not available.

X-Rays for bone age: In a child below 18 years of age, X-Rays are typically done in hand or wrist for the purpose of determining the bone age. Standards of bone age have been derived by comparing the level of maturation of hand and wrist bones with normal age levels.

Your physician will assess ossification of the hand and wrist bones as these have a predictable and age specific pattern of ossification. The ossification patterns are specific until end of adolescence when the elongation of bone is complete.

Other modalities: Your physician may obtain computed tomography (CT) images of medial end of clavicle in individuals aged 18-22 years for age determination. Some alternate methods like ultrasound and magnetic resonance are also used for bone age assessments. Irrespective of the radiographic modality used, you submit the code 77072. This code applies to all radiographic modalities used to assess bone age.