Radiology Coding Alert

Question: When bone density studies ( CPT 76075 ) are used to monitor the effects of long-term steroid therapy, how do you code this? If studies are medically necessary more frequently than the standard (once every 2 years), how do we indicate necessity?

Anonymous IA Subscriber

Answer: Dual energy x-ray absorptiometry (DEXA, bone density study, 76075), is one of four CPT codes approved by Medicare to measure bone mass when medically necessary. (See HCFA Program Memorandum Transmittal No. AB-98-32, effective July 1, 1998). Other codes are 76076 (DEXA, appendicular skeletone.g., radius, wrist, heel), 76078 (radiographic absorptiometryphotodensitometry), and, 78350 (bone density, single photon absorptiometry). A new code added in 1999 is 76977 (ultrasound bone density measurement recognizing recent acceptance of advancements in ultrasound).

HCFA allows specific exception to the once every 2 years frequency standard bone density studies in the case of Monitoring beneficiaries on long-term glucocorticoid (steroid) therapy for more than 3 months.... Based on selective checking of local carrier implementation of the national policy, we recommend using 962.0 (poisoning by hormones and synthetic substitutes) or 995.2 (unspecified adverse effect of drug, medicinal and biological substance) with E932.0 (adrenal cortical steroids). Your local carrier should be contacted to confirm acceptable codes.