Bone Mass Measurement ICD-9 Coding

I am having a problem getting 77081 reimbursed by Medicare when it is billed with 77080. Provider is indicating that ICD-9 codes for 77081 are 733.90 and 275.40. Should I be using a V code as well?

Thank you for any help you can give me.

You should not be doing both

You either test axial 77080 or appendicular 77081 depending on your machine. Doing both is double dipping, and a disservice to the patient and provides no useful additional information (unless you have more information that you are not sharing)

Bone Mass Measurement

Thank you for your response. However, it was my understanding that 77081 can be billed in addition to 77080, but there are limited clinical exceptions where it may be appropriate to perform both axial and peripheral bone density studies on the same date of service. The medical records must substantiate that the original BMM study is unreadable or neither hip nor axial spine can be measured, obese patient over the weight limit for DEXA exam table or extreme arthritic conditions preclude accurate measurement.

However, under normal circumstances, if none of the above are present, per your explanation, we should only be billing 77080; is that correct? Should we only bill 77080 even if we are trying to establish a baseline for further studies as well?

Thank you for your input.

You confuse me

I can't imagine you have both machines - as far as I know there is no machine that does both tests. So you bill based on whether you are imaging the hand/heel/finger or spine/hip.
As to intent (establishing baseline) that does not change your CPT but may change the ICD-9 code you choose.
I agree with your occasional need to do both tests- knew there was an explanation!

Bone Mass Measurement

Thank you for your reply. I now have a more complete understanding of the coding involved.

Bone Density Study policy

The policy for bone densities was updated not too long ago. Your local carrier policy may have been updated, and you can probably check that on line with them. For those who use National Government Services, can access the policy here : http://www.ngsmedicare.com/NGSMedicare/lcd/L26385_active_lcd.htm

Bone Mass Measurement.

Thank you for your comment. I had reviewed the updated LMRP for our area before posing the question, but was a little confused as to the interpretation.