Radiology Coding Alert

Question: I have a report that indicates the physician performed a “DXA scan on the patient’s pelvis and wrists.” I’m new to radiology coding and haven’t coded DXA scans before.

Are bone density scan codes the same as a DXA scan?

Mississippi Subscriber

Answer: Yes, dual-energy X-ray absorptiometry (DXA) scans are the same as bone density scans. In your situation, you’d report both 77080 (Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)) and 77081 (… appendicular skeleton (peripheral) (eg, radius, wrist, heel)) together.

Providers order DXA scans to measure the bone mineral density (BMD) within the patient’s bones. The method calculates the amount of minerals, such as calcium and phosphorus, in a unit area of bone. The provider aims two X-rays of different energy levels at the target bones, and the amount of each beam’s absorption into the bone helps determine the BMD.

In July 2020, the Centers for Medicare and Medicaid Services (CMS) issued Transmittal 10193, which allows you to report 77080 and 77081 together on the same claim by appending modifier XU (Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service) to 77080 (www.cms.gov/files/ document/r10193otn.pdf).

Of course, you should review your individual payer preferences to ensure accurate and correct reporting of the services.