Page 1 of 2 12 LastLast
Results 1 to 10 of 11

Thread: Diag code for Bone Mineral Density Test

  1. #1
    Join Date
    Apr 2007
    Posts
    11

    Default Diag code for Bone Mineral Density Test

    Promo: Code Books
    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!!

  2. #2
    Join Date
    Apr 2007
    Posts
    14

    Default

    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.

  3. #3
    Join Date
    Apr 2007
    Location
    Columbia, MO
    Posts
    12,170

    Default

    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 A. Mitchell, MSPH, CPC-H

  4. #4
    Join Date
    Apr 2007
    Posts
    14

    Default

    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?

  5. #5
    Join Date
    Apr 2007
    Location
    Columbia, MO
    Posts
    12,170

    Default

    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.

    Debra A. Mitchell, MSPH, CPC-H

  6. #6
    Join Date
    Apr 2007
    Location
    Anchorage, Alaska
    Posts
    134

    Default

    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?

  7. #7

    Default 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 by milissalove092005; 10-17-2013 at 01:18 PM.

  8. #8

    Default

    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

  9. #9
    Join Date
    Apr 2007
    Location
    Columbia, MO
    Posts
    12,170

    Default

    Quote Originally Posted by jbrightw View Post
    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.

    Debra A. Mitchell, MSPH, CPC-H

  10. #10
    Join Date
    Apr 2007
    Posts
    28

    Default

    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.

Page 1 of 2 12 LastLast

Similar Threads

  1. Mineral Bone Disorder
    By Happylife in forum Diagnosis Coding
    Replies: 2
    Last Post: 06-17-2015, 11:27 AM
  2. Replies: 2
    Last Post: 07-26-2012, 05:02 PM
  3. Bone Density Code
    By rbapat in forum Family Practice
    Replies: 0
    Last Post: 07-27-2010, 09:19 AM
  4. bone density....? appropriate dx code
    By Kimberley in forum Diagnosis Coding
    Replies: 1
    Last Post: 01-21-2010, 11:47 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.