Latest on CPT and ICD-9 Codes for Accurate Reporting of Bone Density (from SuperCoder's Part B Coder)
Stronger claims come from choosing correct scan types and diagnoses.
Paying attention to three details for your patients' bone density scans can make or break your claims success. Follow our experts' advice regarding the types of tests, appropriate diagnoses, and acceptable timeframes, and you'll build strong claims and healthy bottom lines.
1. Report the Correct Type of Scan
Bone density scans (also known as bone mass measurements, or BMM) fall into five general categories. Your first step in coding is to determine...
...to read the full article, latest CPT guidelines, fee schedules, LCD and CCI edits related to Bone Density Scan codes, subscribe to SuperCoder's Part B Coder.
Take a FREE Trial to see the tool before you subscribe to it.
Diagnosis coding for laboratory work and screening tests such as CAT scans, x-rays and bone density studies can be tricky. But assigning the correct ICD-9 code is essential to receiving reimbursement.
Can you bill a screening test with the diagnosis established after the test is done? writes Brigitte Rose patient accounts manager for Internal Medicine Associates of Grand Junction in Grand Junction CO. For example a patient has a screening bone density during a visit for health maintenance and it showed osteoporosis. Can I bill the screening test with a diagnosis of osteoporosis after the test was performed even though the diagnosis was not yet established when the test was ordered?
No says Dari Bonner CPC CPC-H CCS-P a corporate compliance and coding/reimbursement specialist based in Port St. Lucie FL.
If it starts out as a screening test it must remain a screening test Bonner states. If you are doing it for screening you are talking about an asymptomatic patient who is not having any problems and then you do a screening and then find something. It is still a screening. It would be fraud to report the test with the final diagnosis in this situation.
ICD-9 Code Must Reflect Reason for the Visit
Bonner acknowledges that there is a lot of confusion in this area particularly since there are situations in which you would wait for the final diagnosis before submitting the bill for the test.
In fact the American Medical Associations (AMA) Coding Guidelines for Outpatient Services instruct coders do not code diagnoses documented as probable suspected questionable rule-out or working diagnoses. Rather code the condition to the highest degree of certainty for that encounter/visit such [...]