Wiki DEXA CPT 77080: Screening diag. V82.81

[rmperrington@verizon.net]

I have read that CMS does not allow diagnosis V82.81 osteoporosis, screening by itself when billing the Dexa Scan 77080.

The issue we have is for males over 70 it is recommended that they have a Bone mass measurement screening, but many times the recommended diagnosis codes for medical necessity do not apply to this male population. I do not believe we can bill osteoporosis if it has not been confirmed.

Any input or suggestions would be greatfully appreciated.

Thank you

 

[mitchellde]

If it is for screening purposes regardless of whether it is male or female you must use the screening dx code. Dx coding cannot be based on whether it pays or not but rather if the code matches the documentation. The issue is not that Mcare does not allow this code, it that it is not covered. So the procedure will be patient responsibility.