CPT code 76977, 77078, 77080, 77081 and G0130 - covred ICD 10 and benefit period

Bone Mass Measurements

HCPCS/CPT Codes

76977 – Ultrasound bone density measurement and interpretation, peripheral site(s), any method

77078 – Computed tomography, bone mineral density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)

77080 – Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)

77081 – DXA, bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)

G0130 – Single energy X-ray absorptiometry (SEXA) bone density study, 1 or more sites, appendicular skeleton (peripheral) (eg, radius, wrist, heel)


ICD-10-CM Codes

See https://www.cms.gov/Medicare/Coverage/ CoverageGenInfo/ICD10.html for individual Change Requests (CRs) and coding translations for ICD-10

Who Is Covered

Certain Medicare beneficiaries who fall into at least one of the following categories:

• Women determined by their physician or qualified non-physician practitioner (NPP) to be estrogen deficient and at clinical risk for osteoporosis;

• Individuals with vertebral abnormalities;

• Individuals getting (or expecting to get) glucocorticoid therapy for more than 3 months;

• Individuals with primary hyperparathyroidism; or

• Individuals being monitored to assess response to U.S. Food and Drug Administration (FDA)-approved osteoporosis drug therapy

Frequency

• Every 2 years; or

• More frequently if medically necessary Beneficiary Pays

• Copayment/coinsurance waived
• Deductible waived