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Radiology Coding Alert

Bone Mass Measurement:

77080: 5 Smart Moves for More Accurate BMM Claims

Published on Mon Jul 02, 2012

Separate screening from monitoring for spot-on coding. Bone mass measurement (BMM) has been in the spotlight lately after Medicare once again changed payment calculations for DXA bone density studies. That makes now a great time to review coverage requirements for these common tests. (Hint: Check out section 5 for more about the payment changes.) 1. Verify Order Is From a Qualified Provider For Medicare to cover BMM, the test must be ordered by a physician or qualified nonphysician provider (NPP), according to Medicare Benefit Policy Manual (MBPM), Chapter 15, Section 80.5.4 (www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/bp102c15.pdf). NPPs qualified to order BMM include: Physician assistants Nurse practitioners Clinical nurse specialists Certified nurse midwives. The ordering physician or NPP must be "treating" the patient, evaluate the need for BMM, and determine the appropriate BMM for the patient. "Treating" means either consulting or treating the patient for a specific problem and using the results to further [...]
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