Wiki Bone density/dexa scans

[LMOuellette]

Good Afternoon Everyone,
I am in dire straights. We have been getting several denials from medicare on patients we are billing G0130. The test was ordered and patient had no documented symptoms, no osteoporosis nothing, so we have been billing the V82.81 and then depending on result if patient has osteopenia or porosis, we are using those as a secondary dx, but it is still denying. People keep telling me just too bill the result, but I think that is fraud. Am I doing something wrong? Help would be appreciative.

Thank you.

 

[mitchellde]

Good Afternoon Everyone,
I am in dire straights. We have been getting several denials from medicare on patients we are billing G0130. The test was ordered and patient had no documented symptoms, no osteoporosis nothing, so we have been billing the V82.81 and then depending on result if patient has osteopenia or porosis, we are using those as a secondary dx, but it is still denying. People keep telling me just too bill the result, but I think that is fraud. Am I doing something wrong? Help would be appreciative.

Thank you.

When the reason for the study is screening then you are required to use the screening V code first listed. Any finding will be secondary. Medicare does not routinely cover bone density screenings, so it it usually patient responsibility.

 

[LCL]

The reason for the test is the menopause status etc. and would be primary unless it's a follow up to previous documented osteo

 

[bonn715]

Dexa Scans are a service that an ABN should be signed for, covered in few circumstances so should get one to let pt know liability will most likely be theirs