Radiology Coding Alert

Question: A radiologist in our practice performed a DXA scan on a patient’s spine. I’m new to radiology coding, and I’m not sure which code to assign between 77080 and 77081.

Could you explain how these codes are different?

Maryland Subscriber

Answer: CPT^® codes 77080 (Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)) and 77081 (… appendicular skeleton (peripheral) (eg, radius, wrist, heel)) are both designated for dual-energy X-ray absorptiometry (DXA) scans of the patient’s bones. The main difference between the two codes is that 77080 is designated for axial skeleton scans and 77081 is designated for appendicular skeleton scans.

The axial skeleton makes up the main central core of the body, and consists of the head, spine, ribs, pelvis, hyoid, and sternum bones. If any of these bones are included in the physician’s documentation, then you’ll assign 77080 for a DXA bone density study of the axial skeleton

The appendicular skeleton consists of areas beyond those included in the axial skeleton. The appendicular bones include the pelvic girdle, shoulder girdles, and the extremities (e.g., arms, legs, feet, hands, etc.). You’ll assign 77081 for a DXA bone density study of the appendicular skeleton if the documentation includes these bones.

For the situation you mentioned, you’d assign 77080 to report the DXA scan of the patient’s spine along with any appropriate diagnosis codes.