Wiki Dexa Scan Coding

[jenniferw404]

When coding for dexa scans, if the pt is determined to be at clinical risk for osteoporosis, and estrogen-deficient do you bill with the screening V82.81 or do you use the code 627.2 since Medicare considers them "menopausal state symptomatic".

 

[mitchellde]

it is screening. Just because they are menapausal does not mean they have the condition.

 

[jenniferw404]

Even though according to Medicare it states "If in additon to gender and estrogen-deficiency, a woman has been determined to be at clinical risk for osteoporosis based on her history and other findings, the Carrier will interpret the menopausal state as symptomatic." What does that mean then?

 

[donnajrichmond]

When coding for dexa scans, if the pt is determined to be at clinical risk for osteoporosis, and estrogen-deficient do you bill with the screening V82.81 or do you use the code 627.2 since Medicare considers them "menopausal state symptomatic".

that will be payer specific - check your LCD for how they want these billed.
They should be V82.81, but those contractors who have LCDs have different guidelines for coding.

 

[mitchellde]

Just because the LCD may state to use a dx code for payment does not mean we use that dx code if it is not documented in the patient's charge. At risk for is not something we can code.