October 9, 2015 - Updated 11.24.15
Bone Mass Measurement Coding and Billing Guidelines
With the cancellation of the bone mass measurement (BMM) part of Change Request (CR) 8691 and the diagnosis edit not being implemented by CMS for National Coverage Determination (NCD) 150.3, CGS developed a contractor list of diagnosis for BMM as indicated in the Internet-Only Manual (IOM)100-04, Chapter 13, Section 140. Based on the NCD these are the diagnosis that CGS feels are appropriate based on the information given in the NCD. The correct use of an ICD-9/ ICD-10-CM code listed below does not assure coverage of a service. The service must be reasonable and necessary in the specific case and must meet the criteria specified in IOM sections listed above.
Payable ICD-9 diagnosis for CPT code 77080:
252.01 | 627.9 | 805.01 | 805.14 | 805.9 | 806.11 | 806.23 | 806.35 | 806.71 | V82.81 |
255.0 | 733.00 | 805.02 | 805.15 | 806.00 | 806.12 | 806.24 | 806.36 | 806.72 | |
256.2 | 733.01 | 805.03 | 805.16 | 806.01 | 806.13 | 806.25 | 806.37 | 806.79 | |
256.31 | 733.02 | 805.04 | 805.17 | 806.02 | 806.14 | 806.26 | 806.38 | 806.8 | |
256.39 | 733.03 | 805.05 | 805.18 | 806.03 | 806.15 | 806.27 | 806.39 | 806.9 | |
259.3 | 733.09 | 805.06 | 805.2 | 806.04 | 806.16 | 806.28 | 806.4 | E932.0 | |
627.0 | 733.13 | 805.07 | 805.3 | 806.05 | 806.17 | 806.29 | 806.5 | V45.77 | |
627.1 | 733.90 | 805.08 | 805.4 | 806.06 | 806.18 | 806.30 | 806.60 | V49.81 | |
627.2 | 756.51 | 805.10 | 805.5 | 806.07 | 806.19 | 806.31 | 806.61 | V58.65 | |
627.3 | 758.6 | 805.11 | 805.6 | 806.08 | 806.20 | 806.32 | 806.62 | V58.68 | |
627.4 | 793.7 | 805.12 | 805.7 | 806.09 | 806.21 | 806.33 | 806.69 | V58.69 | |
627.8 | 805.00 | 805.13 | 805.8 | 806.10 | 806.22 | 806.34 | 806.70 | V67.51 |
Payable ICD-9 diagnosis for CPT codes 77078, 77081, 77085, 76977, and HCPCS code G0130:
252.01 | 627.9 | 805.01 | 805.14 | 805.9 | 806.11 | 806.23 | 806.35 | 806.71 |
255.0 | 733.00 | 805.02 | 805.15 | 806.00 | 806.12 | 806.24 | 806.36 | 806.72 |
256.2 | 733.01 | 805.03 | 805.16 | 806.01 | 806.13 | 806.25 | 806.37 | 806.79 |
256.31 | 733.02 | 805.04 | 805.17 | 806.02 | 806.14 | 806.26 | 806.38 | 806.8 |
256.39 | 733.03 | 805.05 | 805.18 | 806.03 | 806.15 | 806.27 | 806.39 | 806.9 |
259.3 | 733.09 | 805.06 | 805.2 | 806.04 | 806.16 | 806.28 | 806.4 | E932.0 |
627.0 | 733.13 | 805.07 | 805.3 | 806.05 | 806.17 | 806.29 | 806.5 | V45.77 |
627.1 | 733.90 | 805.08 | 805.4 | 806.06 | 806.18 | 806.30 | 806.60 | V49.81 |
627.2 | 756.51 | 805.10 | 805.5 | 806.07 | 806.19 | 806.31 | 806.61 | V58.65 |
627.3 | 758.6 | 805.11 | 805.6 | 806.08 | 806.20 | 806.32 | 806.62 | V58.69 |
627.4 | 793.7 | 805.12 | 805.7 | 806.09 | 806.21 | 806.33 | 806.69 | |
627.8 | 805.00 | 805.13 | 805.8 | 806.10 | 806.22 | 806.34 | 806.70 |
Payable ICD-10 diagnosis for CPT code 77080:
E21.0 | S12.041B | S12.24XB | S12.490A | S22.000A | S22.041A | S22.082B | S32.038B | S32.130B |
E24.0 | S12.090A | S12.250A | S12.490B | S22.000B | S22.041B | S22.088A | S32.039A | S32.131A S32.132B |
E24.2-E24.4 | S12.090B | S12.250B | S12.491A | S22.001A | S22.042A | S22.088B | S32.039B | S32.132A S32.132B |
E24.8-E24.9 | S12.091A | S12.251A | S12.491B | S22.001B | S22.042B | S22.089A | S32.040A | S32.139A |
E28.310 | S12.091B | S12.251B | S12.500A | S22.002A | S22.048a | S22.089B | S32.040B | S32.139B |
E28.319 | S12.100A | S12.290A | S12.500B | S22.002B | S22.048B | S32.000A | S32.041A | S32.14XA |
E28.39 | S12.100B | S12.290B | S12.501A | S22.008A | S22.049A | S32.000B | S32.041B | S32.14XB |
E34.2 | S12.101A | S12.291A | S12.501B | S22.008B | S22.049B | S32.001A | S32.042A | S32.15XA |
E89.40-E89.41 | S12.101B | S12.291B | S12.530A | S22.009A | S22.050A | S32.001B | S32.042B | S32.15XB |
M48.50XA-M48.58XA | S12.110A | S12.300A | S12.530B | S22.009B | S22.050B | S32.002A | S32.048A | S32.16XA |
M80.08XA | S12.110B | S12.300B | S12.531A | S22.010A | S22.051A | S32.002B | S32.048B | S32.16XB |
M80.88XA | S12.111A | S12.301A | S12.531B | S22.010B | S22.051B | S32.008a | S32.049A | S32.17XA |
M84.58XA | S12.111B | S12.301B | S12.54XA | S22.011A | S22.052A | S32.008B | S32.049B | S32.17XB |
M84.68XA | S12.112A | S12.330A | S12.54XB | S22.011B | S22.052B | S32.009A | S32.050A | S32.19XA |
M81.0 | S12.112B | S12.330B | S12.550A | S22.012A | S22.058A | S32.009B | S32.050B | S32.19XB |
M81.6 | S12.120A | S12.331A | S12.550B | S22.012B | S22.058B | S32.010A | S32.051A | S32.2XXA |
M81.8 | S12.120B | S12.331B | S12.551A | S22.018A | S22.059A | S32.010B | S32.051B | S32.2XXB |
M85.9 | S12.121A | S12.34XA | S12.551B | S22.018B | S22.059B | S32.011A | S32.052A | T38.0X5A |
M89.9 | S12.121B | S12.34XB | S12.590A | S22.019A | S22.060A | S32.011B | S32.052B | T38.0X5S |
M94.9 | S12.130A | S12.350A | S12.590B | S22.019B | S22.060B | S32.012A | S32.058A | T50.0X5A |
N92.4 | S12.130B | S12.350B | S12.591A | S22.020A | S22.061A | S32.012B | S32.058B | T50.0X5S |
N95.0-N95.2 | S12.131A | S12.351A | S12.591B | S22.020B | S22.061B | S32.018A | S32.059A | Z09 |
N95.8-N95.9 | S12.131B | S12.351B | S12.600A | S22.021A | S22.062A | S32.018B | S32.059B | Z79.3 |
Q78.0 | S12.14XA | S12.390A | S12.600B | S22.021B | S22.062B | S32.019A | S32.10XA | Z79.51 |
Q96.0-Q96.4 | S12.14XB | S12.390B | S12.601A | S22.022a | S22.068A | S32.019B | S32.10XB | Z79.52 |
Q96.8-Q96.9 | S12.150a | S12.391A | S12.601B | S22.022B | S22.068B | S32.020A | S32.110A | Z79.83 |
R93.6-R93.7 | S12.150B | S12.391B | S12.630a | S22.028A | S22.069A | S32.020B | S32.110B | Z78.0 |
S12.000A | S12.151A | S12.400A | S12.630B | S22.028B | S22.069B | S32.021A | S32.111A | Z79.51 |
S12.000B | S12.151B | S12.400B | S12.631A | S22.029A | S22.070A | S32.021B | S32.111B | Z79.52 |
S12.001A | S12.190A | S12.401A | S12.631B | S22.029B | S22.070B | S32.022A | S32.112A | Z90.721 |
S12.001B | S12.190B | S12.401B | S12.64XA | S22.030A | S22.071A | S32.022B | S32.112B | Z90.722 |
S12.01XA | S12.191A | S12.430A | S12.64XB | S22.030B | S22.071B | S32.028A | S32.119A | Z90.79 Z13.820 M85.80 |
S12.01XB | S12.191B | S12.430B | S12.650A | S22.031A | S22.072A | S32.028B | S32.119B | M85.811 |
S12.02XA | S12.200A | S12.431A | S12.650B | S22.031B | S22.072B | S32.029A | S32.120A | M85.812 |
S12.02XB | S12.200B | S12.431B | S12.651A | S22.032A | S22.078A | S32.029B | S32.120B | M85.821 |
S12.030A | S12.201A | S12.44XA | S12.651B | S22.032B | S22.078B S22.079A |
S32.030A | S32.121A | M85.822 |
S12.030B | S12.201B | S12.44XB | S12.690A | S22.038A | S22.079B | S32.030B | S32.121B | M85.831 |
S12.031A | S12.230A | S12.450A | S12.690B | S22.038B | S22.080A | S32.031A | S32.122A | M85.832 |
S12.031B | S12.230B | S12.450B | S12.691A | S22.039A | S22.080B | S32.031B | S32.122B | M85.841 |
S12.040A | S12.231A | S12.451A | S12.691B | S22.039B | S22.081A | S32.032A | S32.129A | M85.842 |
S12.040B | S12.231B | S12.451B | S12.9XXA | S22.040A | S22.081B | S32.032B | S32.129B | M85.851 |
S12.041A | S12.24XA | S22.040B | S22.082A | S32.038A | S32.130A | M85.852 M85.861 M85.862 M85.871 M85.872 M85.88 M85.89 |
Payable ICD-10 for CPT codes 77078, 77081, 77085, 76977 and HCPCS code G0130:
E21.0 | S12.041B | S12.24XB | S12.490A | S22.000A | S22.041A | S22.082B | S32.038B | S32.130B |
E24.0 | S12.090A | S12.250A | S12.490B | S22.000B | S22.041B | S22.088A | S32.039A | S32.131A S32.131B |
E24.2-E24.4 | S12.090B | S12.250B | S12.491A | S22.001A | S22.042A | S22.088B | S32.039B | S32.132A S32.132B |
E24.8-E24.9 | S12.091A | S12.251A | S12.491B | S22.001B | S22.042B | S22.089A | S32.040A | S32.139A |
E28.310 | S12.091B | S12.251B | S12.500A | S22.002A | S22.048a | S22.089B | S32.040B | S32.139B |
E28.319 | S12.100A | S12.290A | S12.500B | S22.002B | S22.048B | S32.000A | S32.041A | S32.14XA |
E28.39 | S12.100B | S12.290B | S12.501A | S22.008A | S22.049A | S32.000B | S32.041B | S32.14XB |
E34.2 | S12.101A | S12.291A | S12.501B | S22.008B | S22.049B | S32.001A | S32.042A | S32.15XA |
E89.40-E89.41 | S12.101B | S12.291B | S12.530A | S22.009A | S22.050A | S32.001B | S32.042B | S32.15XB |
M48.50XA-M48.58XA | S12.110A | S12.300A | S12.530B | S22.009B | S22.050B | S32.002A | S32.048A | S32.16XA |
M80.08XA | S12.110B | S12.300B | S12.531A | S22.010A | S22.051A | S32.002B | S32.048B | S32.16XB |
M80.88XA | S12.111A | S12.301A | S12.531B | S22.010B | S22.051B | S32.008a | S32.049A | S32.17XA |
M84.58XA | S12.111B | S12.301B | S12.54XA | S22.011A | S22.052A | S32.008B | S32.049B | S32.17XB |
M84.68XA | S12.112A | S12.330A | S12.54XB | S22.011B | S22.052B | S32.009A | S32.050A | S32.19XA |
M81.0 | S12.112B | S12.330B | S12.550A | S22.012A | S22.058A | S32.009B | S32.050B | S32.19XB |
M81.6 | S12.120A | S12.331A | S12.550B | S22.012B | S22.058B | S32.010A | S32.051A | S32.2XXA |
M81.8 | S12.120B | S12.331B | S12.551A | S22.018A | S22.059A | S32.010B | S32.051B | S32.2XXB |
M85.9 | S12.121A | S12.34XA | S12.551B | S22.018B | S22.059B | S32.011A | S32.052A | T38.0X5A |
M89.9 | S12.121B | S12.34XB | S12.590A | S22.019A | S22.060A | S32.011B | S32.052B | T38.0X5S |
M94.9 | S12.130A | S12.350A | S12.590B | S22.019B | S22.060B | S32.012A | S32.058A | T50.0X5A |
N92.4 | S12.130B | S12.350B | S12.591A | S22.020A | S22.061A | S32.012B | S32.058B | T50.0X5S |
N95.0-N95.2 | S12.131A | S12.351A | S12.591B | S22.020B | S22.061B | S32.018A | S32.059A | Z79.3 |
N95.8-N95.9 | S12.131B | S12.351B | S12.600A | S22.021A | S22.062A | S32.018B | S32.059B | |
Q78.0 | S12.14XA | S12.390A | S12.600B | S22.021B | S22.062B | S32.019A | S32.10XA | Z78.0 |
Q96.0-Q96.4 | S12.14XB | S12.390B | S12.601A | S22.022a | S22.068A | S32.019B | S32.10XB | Z79.51 |
Q96.8-Q96.9 | S12.150a | S12.391A | S12.601B | S22.022B | S22.068B | S32.020A | S32.110A | Z79.52 |
R93.6-R93.7 | S12.150B | S12.391B | S12.630a | S22.028A | S22.069A | S32.020B | S32.110B | Z90.721 |
S12.000A | S12.151A | S12.400A | S12.630B | S22.028B | S22.069B | S32.021A | S32.111A | Z90.722 |
S12.000B | S12.151B | S12.400B | S12.631A | S22.029A | S22.070A | S32.021B | S32.111B | Z90.79 M85.80 |
S12.001A | S12.190A | S12.401A | S12.631B | S22.029B | S22.070B | S32.022A | S32.112A | M85.811 |
S12.001B | S12.190B | S12.401B | S12.64XA | S22.030A | S22.071A | S32.022B | S32.112B | M85.812 |
S12.01XA | S12.191A | S12.430A | S12.64XB | S22.030B | S22.071B | S32.028A | S32.119A | M85.821 |
S12.01XB | S12.191B | S12.430B | S12.650A | S22.031A | S22.072A | S32.028B | S32.119B | M85.822 |
S12.02XA | S12.200A | S12.431A | S12.650B | S22.031B | S22.072B | S32.029A | S32.120A | M85.831 |
S12.02XB | S12.200B | S12.431B | S12.651A | S22.032A | S22.078A | S32.029B | S32.120B | M85.832 |
S12.030A | S12.201A | S12.44XA | S12.651B | S22.032B | S22.078B S22.079A |
S32.030A | S32.121A | M85.841 |
S12.030B | S12.201B | S12.44XB | S12.690A | S22.038A | S22.079B | S32.030B | S32.121B | M85.842 |
S12.031A | S12.230A | S12.450A | S12.690B | S22.038B | S22.080A | S32.031A | S32.122A | M85.851 |
S12.031B | S12.230B | S12.450B | S12.691A | S22.039A | S22.080B | S32.031B | S32.122B | M85.852 |
S12.040A | S12.231A | S12.451A | S12.691B | S22.039B | S22.081A | S32.032A | S32.129A | M85.861 |
S12.040B | S12.231B | S12.451B | S12.9XXA | S22.040A | S22.081B | S32.032B | S32.129B | M85.862 |
S12.041A | S12.24XA | S22.040B | S22.082A | S32.038A | S32.130A | M85.871 M85.872 M85.88 M85.89 |