Skip to Main Content

Print | Bookmark | Email | Font Size: + |

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 DeterminationExternal website (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 140External PDF. 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  

Back to the top of the pageTop

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  

Back to the top of the pageTop

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

Back to the top of the pageTop

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

Back to the top of the pageTop

26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved