Question about Medicare fee schedule

coder25

Guru
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Lehigh Valley
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Good afternoon!

My manager asked me to locate what Medicare will pay for a bone densimeter. They are looking into purchasing a machine. I found a couple of CPT codes, but not sure which one I am supposed to use and was hoping someone could help.

Codes I could find on Highmark Medicare site were:

G0130
77083
77081

Which ones would I use to code, HCPCS alone or with another CPT code.

Thanks in advance for your help!
 

MMAYCOCK

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These are different tests, so it will depend on which ones you are conducting. 77081 DUAL-ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, 1 OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL)
77083 RADIOGRAPHIC ABSORPTIOMETRY (EG, PHOTODENSITOMETRY, RADIOGRAMMETRY), 1 OR MORE SITES
G0130 SINGLE ENERGY X-RAY ABSORPTIOMETRY (SEXA) BONE DENSITY STUDY, ONE OR MORE SITES; APPENDICULAR SKELETON (PERIPHERAL) (EG, RADIUS, WRIST, HEEL)

Here is a current coverage determination from CMS. It has descriptions of what is covered and when.
http://www.cms.gov/mcd/viewlcd.asp?lcd_id=22207&lcd_version=15&basket=lcd:22207:15:Bone+Mass+Measurements+(BMMs)+(previously+Measurement+of+Bone+Density):Carrier:CIGNA+Government+Services+(05130):
 

velma

New
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Anaheim
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Hi Guru,
My manager asked me the same thing. I went on the link suggested above and it does not give a price for anything. We are wanting to purchase the US bone density 76977. If you find out what medicare pays could you please let me know? Thank you
Velma CPC
 
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