Date Issued: 3/23/2018
We are providing this updated information based on the recommendation by the American College of Radiology and the International Society for Clinical Densitometry for the following CPT codes:
77080 – Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)
77081 – Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (eg, radius, wrist, heel)
Effective June 26, 2018, dual-energy X-ray absorptiometry (DXA) bone density screening (CPT Codes 77080 or 77081) is not indicated for males, less than 70 years of age, without risk factors for osteoporosis.
Therefore, DXA bone density studies (77080 or 77081) will be denied when the only diagnosis on the claim is osteoporosis screening (ICD-10 code Z13.820) for a male who is less than 70 years of age.
Note: For information on guidelines regarding cost-share exemption for bone density screening for females over age of 60 under the commercial line of business please see EmblemHealth Preventive Care/Screening Services Exempt from Cost-Share.