Wiki V76.12 Principle Diagnosis?

[shaelizur]

I need some assistance. I ran into a situation at the office while reviewing claims that were denied. One claim was denied specifically "cpt 77080 inconsistent w/dx V76.12". After doing additional research, I was informed that V76.12 may not be used as a principle diagnosis.
Is this correct? If so why? Can someone explain?

Thanks

 

[cynthiabrown]

77080 is bone density why would you append v76.12 screening mammo which can certainly be first listed on a procedure for screening of breat

 

[rryder1963]

Bone Density ICD-9 Codes

CMS has a NCD for bone density tests. Try this link:


http://www.cms.gov/medicare-coverag....aspx?NCDId=256&ncdver=2&bc=AAAAgAAAAAAAAA==&

I see nothing that prohibits using V76.12 as primary dx--but it does need to be attached to the appropriate CPT code for reimbursement.