Radiology Coding Alert

Answer: You will report only 76499 (Unlisted diagnostic radiographic procedure) for the procedure. When you search for 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)) in the AMA CPT^® code set, you’ll find a parenthetical note after 77081 that states “For dual energy X-ray absorptiometry [DXA] body composition study, use 76499.”

A DXA body composition study is a pain-free, comprehensive study that provides a detailed analysis of the patient’s bone density, lean mass, and fat tissue. Currently, the AMA CPT^® code set doesn’t have a specific code that represents a DXA body composition study, which is why you are instructed to assign an unlisted procedure code.

Code 76499 is a catch-all radiology code to report diagnostic radiographic procedures that aren’t assigned a specific CPT^® code. If a code existed in the CPT^® code set that specified the DXA body composition study, including a Category III code, you would assign the appropriate code. However, since no code exists that represents the procedure, you’ll assign the unlisted procedure code.

The AMA CPT^® guidelines prior to the Radiology codes also instruct you to identify the service by submitting a “Special Report” that explains the reason for choosing an unlisted code instead of an active, defined code.