Urology Coding Alert

Question: How should I code a Dexa bone mineral density study for prostate cancer patients who are undergoing hormonal manipulation?

Alaska Subscriber

Answer: Report the procedure using 77080 (Dual-energy x-ray absorptiometry [DXA], bone density study, 1 or more sites; axial skeleton [e.g., hips, pelvis, spine]) for the bone scan. Along with 77080, you should use diagnosis codes 733.09 (Osteoporosis; other), which includes "drug-induced osteoporosis" and 185 (Malignant neoplasm of prostrate), in that order.

Alternative: Other appropriate ICD-9 codes would include V58.69 (Long term [current] use of other medications) and E932.9 (Other and unspecified hormones and synthetic substitutes).

Note: Payers allow bone mass measurements only every two years. Also, use place of service code 11 (Office) or 49 (Independent clinic) for this claim.