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Question about Medicare fee schedule

  1. #1
    Default Question about Medicare fee schedule
    Medical Coding Books
    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!

  2. Default
    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?l...%2805130%29%3A

  3. #3
    Default
    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

  4. Default
    G0130 38.93
    26 11.74
    tc 27.19

  5. Default
    77081 33.54
    26 11.68
    tc 23.04

    77083 29.11
    26 10.62
    tc 18.48

  6. Default
    76977 12.20
    26 2.84
    tc 9.36

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