Radiology Coding Alert

Question: When a patient has had a previous bone mineral density study with an x-ray finding of osteopenia and it is recommended that the patient have a follow-up study, which diagnosis code should be used?

Washington Subscriber

Answer: In this instance, ICD-9 code 733.90 (disorder of bone and cartilage, unspecified) most closely describes this situation and is payable in many states, but coders should check with their local Medicare carrier guidelines.

In general, radiology coders should note that Medicare may cover bone density studies for beneficiaries once every two years on a qualified individual, provided at least 23 months has elapsed since the last bone density study. One way a patient may qualify for coverage is if the patient has vertebral abnormalities such osteoporosis, osteopenia or vertebral fractures indicated by x-ray. Diagnosis codes 733.00-733.09 are covered codes per Medicare guidelines.