Wiki Diag code for Bone Mineral Density Test

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Code: Z13.820

Code Name: ICD-10 Code for Encounter for screening for osteoporosis

Block: Encounter for screening for osteoporosis

Z13.8

Excludes2: screening for malignant neoplasms (Z12.-)

Z13

Excludes1: encounter for diagnostic examination-code to sign or symptom

Details: Persons encountering health services for examinations (Z00-Z13)

Note: Nonspecific abnormal findings disclosed at the time of these examinations are classified to categories R70-R94.

Excludes 1:examinations related to pregnancy and reproduction (Z30-Z36, Z39.-)

Guidelines: Factors influencing health status and contact with health services (Z00-Z99)

Note: Z codes represent reasons for encounters. A corresponding procedure code must accompany a Z code if a procedure is performed. Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00-Y99 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
(a) When a person who may or may not be sick encounters the health services for some specific purpose, such as to receive limited care or service for a current condition, to donate an organ or tissue, to receive prophylactic vaccination (immunization), or to discuss a problem which is in itself not a disease or injury.
(b) When some circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury.

For more details on Z13.820 , ICD-10 Code for Encounter for screening for osteoporosis , visit: https://coder.aapc.com/icd-10-codes/

dawnpharr

Contributor
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Eastpoint, FL
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We have 2 types of pts that get a Bone Mineral Density test - cpt 77078 - the first are people that we are screening for osteoporosis and the second are the people who already have it and we are monitoring it.

Medicare just released some new guidelines for the appropriate diagnosis codes for this, but I'm having a hard time interpreting them. Our hospital says that Medicare requires 2 diag codes and that we can't use Osteoporosis (733.00) and post menopausal (V49.81).

Can someone help? I need to know, specifically, what diag we need to use so that the hospital can bill Medicare and get paid and quit telling our pts that "the way the dr ordered it, Medicare probably won't pay for it."

Thanks!!
 

Debra

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For Screening, I would use the V82.81 as the Primary Dx, followed by the 733.00 if the results are Osteoporosis. If it is a Screening because the patient is post-menopausal, then I would code the V82.81 and V49.81. What I read is that if you are billing a Screening, you must use the Screening code as well as the reason that Osteoporosis is suspected.

I would also make sure that the Dr. is ordering this as a Screening, I have seen many Dr.s that aren't, which means it cannot be billed as such and then the patient will be billed.
 

mitchellde

True Blue
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Columbia, MO
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I agree with using the screening code first listed as that goes according to coding guidelines, and list a finding if any second. In the previous post it states: "you must use the Screening code as well as the reason that Osteoporosis is suspected" You cannot code a suspected condition so you code only the screening plus any definitive finding.
If the pateint has osteoporosis and they are on mediciation and we do a bone density study to check the status then this study will be coded as a drug monitoring encounter V58.83 first listed folowed by the V58.69 and then the osteoporosis. This is stated in Coding clinics as well.
 

Debra

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True, suspected conditions cannot be coded, however if a Screening is ordered due to Post-menopausal, V49.81, and the report is negative of findings, you can use the V82.81 and the V49.81. Based on the guidelines I read, you cannot code just the V82.81, you have to code the reason why the screening is being performed. Am I missing something?
 

mitchellde

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No I agree with you I just wanted to clarify. V 82.81 requires an additional code be appended. I have had several coders use osteoporosis as the principle dx as they were told to code what was being looked for which is incorrect.
 
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Anchorage, Alaska
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What about this scenario: pt has her first screening dexascan and she is postmenopausal, and the results of the dexascan show osteoporosis. Do you code V82.81, V49.81 or V82.82 and 733.01?
 
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bone mass density study billing

Please outline for me.

If the patient has documentatin in her chart she has a medical dx reason to have the test performed -- this is no longer screening this is Medical and applies to the patients medical benefits. If truely the patient has not been dx with a medical condition we can use the screen dx codes. Correct?
Simple break down: Medical if dx in chart; medical dx on order. No medical dx -screening on the order. simple; right???
Please advise.
 
Last edited:

jbrightw

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Tips to code BMA Dexa scan is that if there is an order for screening present, code V82.81 and the findings as Sdx (733.00, 733.90 etc)

If the scan is indicated for a condition, don't code V82.81, but code 733.00 or 733.90 if found along with the condition as sdx.

If the scan is ordered for a patient who is on long term medications, Use V58.6x also along with above.

If ordered for routine aftercare of organ transplant, use V58.65 (Long term use of steroids) if documented, along with other findings.

Brightwin
 

mitchellde

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Columbia, MO
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Tips to code BMA Dexa scan is that if there is an order for screening present, code V82.81 and the findings as Sdx (733.00, 733.90 etc)

If the scan is indicated for a condition, don't code V82.81, but code 733.00 or 733.90 if found along with the condition as sdx.

If the scan is ordered for a patient who is on long term medications, Use V58.6x also along with above.

If ordered for routine aftercare of organ transplant, use V58.65 (Long term use of steroids) if documented, along with other findings.

Brightwin
Coding clinics state that if a patient is currently being treated for osteoporosis and a bone density is ordered than you use the V58.83 for therapeutic drug monitoring as the first listed code followed by the V58.69 for the long term drug and the osteo can be added as a third listed code.
 

Lizz B

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I'm running into the following a lot: doc orders DEXA with dx of osteoporosis. It is not stated that it is a diagnostic exam or a screening. Radiology REPORT is titled DEXA scan and below that is 'screening for osteoporosis'. I'll admit, I'm totally confused. With Mammos, they indicate screening OR diagnostic on the order. DEXAs, a lot of the time, they don't bother to tell you which it is. If the ordering physician does not indicate either/or, and the radiologist dictates the report for a screening, is is appropriate to code it as a screening? Or does the order need to indicate one or the other?

Any help is appreciated. Thanks.:confused:
 
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Portable bone density

Would these same ways of coding for the bone density apply for a portable x-ray/ultrasound service? I knew of the new Medicare guidelines, but was unsure how to present this to our staff due to how confusing CMS can be.
 
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