Radiology Coding Alert

Question: What are the documentation, diagnosis, and bundling guidelines for 76077? May I report it in addition to 76075 as a screening test?


Michigan Subscriber


Answer: You may report these codes together, if you meet certain requirements.

To report a vertebral facture assessment (VFA), use 76077 (Dual energy x-ray absorptiometry [DXA], bone density study, one or more sites; vertebral fracture assessment). This exam can be performed and coded in conjunction with a screening bone density study:

• 76075--...axial skeleton (e.g., hips, pelvis, spine)
• 76076--...appendicular skeleton (peripheral) (e.g., radius, wrist, heel).  Why: For VFA, radiologists use DXA equipment to obtain AP and lateral views of the thoracic and lumbar spine to determine a patient's potential for future fractures and whether the patient needs pharmacological intervention. Radiologists often acquire VFA images at the same time as a DXA study, and in this case, you may separately report both the DXA and VFA studies.

If the patient had a central DXA study performed previously, you should report only the VFA study code, according to the American College of Radiology.

Caution: Be sure that you have an order from the patient's treating physician that specifically mentions the vertebral fracture assessment before reporting 76077. 

Even with an order from the referring physician for both a bone density study and a fracture assessment, some payers will pay only for the bone density study.