Osteopenia Dx for vit D labs

sopka9476

Contributor
Messages
15
Location
Cameron, NC
Best answers
0
Hello, I have been using M85.89 for osteopenia, multiple sites unfortunately I have some lab claims being rejected. Since there is no a specific ICD-10 code for osteopenia I am interested in what code others are using for osteopenia specifically for their vit D labs. I look forward to any suggestions one may have, thanks.
 
Last edited by a moderator:
Per ICD index Osteopenia falls under M85.8- Disorders of bone density and structure. You would then select based on Site, Multiple sites, Unspecified and Other/NEC. Maybe they want the site and not just the multiple sites code?

I'm not sure about your region but in my MAC NGS LCD L33556 lists the DX M85.89 as covered and also agrees with the index selection. I do see there is an annual limitation on number of vitamin D levels so that could be an issue as well. A few DX (other than Osteopenia) get 4 a year the rest once per year

**Osteopenia should be reported using ICD-10-CM codes M85.80, M85.831-M85.839, M89.851-M85.859, M85.88, M85.89, M85.9 or M89.9

Quest Diagnostics has a helpful guide by state for Medicare lab policies

http://www.questdiagnostics.com/home/physicians/medicare-policies.html
 
Last edited:
We ran into this situation at our facility, too. I was using M85.89 as well and getting denials. When I researched it, I found the description really didn't match osteopenia, imho. This seems more like we would use for our bone density codes. When I looked osteopenia up in the ICD-10 book it took me to M85.89. So, I went and pulled out my old ICD-9 book and looked at 733.90 to get the description. I saw that it stated underneath that the ICD-10 code for it would be M89.9. This description for M89.9 matches the description for 733.90, disorder of bone, unspecified site.

Did more research online and found that under ICD-10-CM, the term “Osteopenia” is indexed to ICD-10-CM subcategory M85.8- Other specified disorders of bone density and structure, within the ICD-10-CM Alphabetic Index. The codes within this subcategory were inadvertently omitted from the CMS spreadsheet that accompanied CR 9252 containing the list of covered conditions and corresponding diagnosis codes. These are considered covered for NCD 150.3 indications.

So I have been using M89.9 on Vitamin D labs when the patient has osteopenia since then with no further problems.
Hope that helps! :)
Melanie


Hello, I have been using M85.89 for osteopenia, multiple sites unfortunately I have some lab claims being rejected. Since there is no a specific ICD-10 code for osteopenia I am interested in what code others are using for osteopenia specifically for their vit D labs. I look forward to any suggestions one may have, thanks.
 
Top