Forum - Questions & Answers

Sep 9th, 2009 - cinnnamon 13 

how to code post-menopausal patient is having a bone density test to evaluate for osteoporosis

I'm stumped on this one. Outpatient/ ER claim

A patient whos post-menopausal is having a bone density test to evaluate her for osteoporosis. Not much info given to determine if patient already has osteoporosis or is being test for this disease. Thanks! I'm trying to see if I need to code the postmenopausal, the bone density test and for the osteoporosis or not. the reason of the test.

Sep 9th, 2009 - nmaguire   2,606 

bone density

"Evaluate for"- means screening if no additional information. Why is this being done in the ER? Medicare covers bone density testing for the following individuals aged 65 and older:
•Estrogen-deficient women at risk for osteoporosis
•Individuals with spinal abnormalities
•Individuals receiving, or planning to receive, long-term glucocorticoid (steroid) therapy
•Individuals with primary hyperparathyroidism
•Individuals being monitored to assess the response or efficacy of an approved osteoporosis drug therapy
Medicare permits individuals to repeat bone density testing every two years

Sep 9th, 2009 - handmaid   13 

outpatient test

Typically, the codes for this would be V82.81 and V49.81 would be used for these types of cases.

Sep 9th, 2009 -

I always use

627.2 (menopause) and always get paid.

Sep 10th, 2009 - cinnnamon 13 

So the sequencing would be?

627.2, V82.81 and V49.81? So this would be the sequencing in order to get paid. Thanks!

Sep 10th, 2009 -

no

just 627.2. When I do a CBC for abd pain, I code 789.01; I do not code for screening for cancer, ulcer disease, etc. even though that's what is banging around in my brain. I use the most specific diagnosis at the time of the testing. I am doing a bone density because the patient has menopause.

Sep 10th, 2009 - cinnnamon 13 

These test are under Auxilliary, so the guidelines apply.

Thanks but the codes for the V82.81 and V49.81, were right on.

I forgot when .. my insomnia is really getting me.. ughhh. But when you code for a lab, x-ray, or other services in Outpatient Coding.

The primary code can be the reason the pt went to the visit as the dx of what the x-ray is for such as : Pt went to have an x-ray for chest congestion or rule out COPD, etc. You would code the symptom ( if no dx by was physician) or the Dx was given such as a pt having pneumonia after radiology show the test to by accurate, than you code that Dx for reason of visit.

But thank you all so much.



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