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L.6.01.412
Bone mineral density (BMD) can be measured with a variety of techniques in a variety of central (i.e., hip or spine) or peripheral (i.e., wrist, finger, heel) sites. While BMD measurements are predictive of fragility fractures at all sites, central measurement of the hip and spine are the most predictive. Fractures of the hip and spine (i.e., vertebral fractures) are also considered to be the most clinically relevant.
There are multiple technologies for non-invasive measurement of bone content which are available. At the time of this writing they included dual energy X-Ray absorptiometry (DEXA), quantitative computed tomography (QCT), ultrasound densitometry, single energy x-ray absorptiometry (SEXA), quantitative ultrasound (QUS), radiographic absorptiometry or photodensitometry, single-photon absorptiometry (SPA), and dual-photon absorptiometry (DPA).
Note that the above list may not be comprehensive as the technology is constantly changing. SPA and DPA are now rarely used and may be considered obsolete. The following technologies are most commonly used:
A. Dual Energy X-Ray Absorptiometry (DEXA)
DEXA measures bone mineral content and bone mineral density. It is a two-dimensional projection system in which an X-ray tube source, rather than a radioisotope, is used as a photon source, providing for more accurate and precise readings. DEXA is used to measure bone mineral in both the peripheral appendicular skeleton and in axial skeletal sites, e.g., wrists, hip, spine, or total skeleton.
B. Quantitative Computed Tomography (QCT)
QCT depends on the differential absorption of ionizing radiation by calcified tissue and is used for central measurements only. Compared to DEXA, QCT is less readily available and associated with relatively high radiation exposure and relatively high costs.
C. Ultrasound Densitometry
Ultrasound densitometry is a technique for measuring BMD at peripheral sites, typically the heel, but also the tibia and phalanges. Compared to osteoporotic bone, normal bone demonstrates higher attenuation of the ultrasound wave, and is associated with a greater velocity of the wave passing through bone. Ultrasound densitometry has no radiation exposure, and machines may be purchased for use in an office setting.
Baseline Screening
Bone density measurements are covered once per lifetime for general screening for osteoporosis for women beginning at age 65 as part of the Healthy You! Wellness benefit. Measurements for screening are limited to the hips or spine using the DEXA technique.
Risk Assessment
The decision to perform bone density assessment should be based on an individual's fracture risk profile and skeletal health assessment. Bone mineral density (BMD) measurement is not indicated unless the results will influence treatment decisions.
Initial, Repeat and Serial BMD
A. An initial measurement of BMD at the hip or spine may be considered medically necessary to assess fracture risk and the need for pharmacologic therapy in both women and men who are considered at risk for osteoporosis. Therefore, BMD testing may be considered medically necessary for the following conditions:
Women age 65 and older, regardless of risk factors
Men age 70 and older, regardless of risk factors
Younger postmenopausal women with one or more risk factors for osteoporosis*
Men age 50-70, where there is concern based on their risk factors*
Adults with a condition or taking a medication listed below associated with low bone mass or bone loss*
*Risk factors included in the WHO Fracture Risk Assessment Model (FRAX) are:
Low body mass index
Parental history of hip fracture
Previous fragility fracture in adult life (i.e., occurring spontaneously, or a fracture arising from trauma which, in a healthy individual, would not have resulted in a fracture)
Currently smoking or alcohol 3 or more units/day, where an unit is equivalent to a standard glass of beer (285ml), a singer measure of spirits (30ml), a medium sized glass of wine (120ml), or 1 measure of an aperitif (60ml)
A disorder strongly associated with osteoporosis. These include rheumatoid arthritis, type I (insulin dependent) diabetes, osteogenesis imperfecta in adults, untreated long-standing hyperthyroidism, hypogonadism, or premature menopause (<45 years), chronic malnutrition or malabsoprtion, or chronic liver disease
Current exposure to oral glucocorticoids, or the patient has been exposed to oral glucocorticoids for more than 3 months at a dose of prednisolone of 5 mg daily or more (or equivalent doses of other glucocorticoids)
Long-term use of anticonvulsant/antiepileptic medications
B. Repeat measurements for individuals with risk factors who previously tested normal may be considered medically necessary at an interval not more than every 5 years.
C. Serial measurements to monitor treatment response for individuals with risk factors may be considered medically necessary not more frequent than every 3 years when the information will affect treatment decisions such as duration of therapy.
D.Serial measurements to monitor bone density for individuals on aromatase inhibitors may be considered medically necessary not more frequent than every 2-3 years when the information will affect treatment decisions. Currently, three aromatase inhibitors are approved by the FDA: letrozole (Femara®), anastrazole (Arimidex®), and exemestane (Aromasin®).
State Health Plan (State and School Employees): Bone density studies are covered for women once every 2 years beginning at age 60 under the Plan's wellness benefits.
The coverage guidelines outlined in the Medical Policy Manual should not be used in lieu of the Member's specific benefit plan language.
Services performed outside the clinical indications contained in the Medical Policy will be considered not medically necessary.
Medically Necessary is defined as those services, treatments, procedures, equipment, drugs, devices, items or supplies furnished by a covered Provider that are required to identify or treat a Member's illness, injury or Mental Health Disorders, and which Company determines are covered under this Benefit Plan based on the criteria as follows in A through D:
A. consistent with the symptoms or diagnosis and treatment of the Member's condition, illness, or injury; and
B. appropriate with regard to standards of good medical practice; and
C. not solely for the convenience of the Member, his or her Provider; and
D. the most appropriate supply or level of care which can safely be provided to Member. When applied to the care of an Inpatient, it further means that services for the Member's medical symptoms or conditions require that the services cannot be safely provided to the Member as an Outpatient.
For the definition of medical necessity, “standards of good medical practice” means standards that are based on credible scientific evidence published in peer-reviewed medical literature generally recognized by the relevant medical community, and physician specialty society recommendations, and the views of medical practitioners practicing in relevant clinical areas and any other relevant factors. BCBSMS makes no payment for services, treatments, procedures, equipment, drugs, devices, items or supplies which are not documented to be Medically Necessary. The fact that a Physician or other Provider has prescribed, ordered, recommended, or approved a service or supply does not in itself, make it Medically Necessary.
4/1993: Approved by Medical Policy Advisory Committee (MPAC).
2/1997: Expanded clinical indications approved by MPAC. Limited to DEXA method only, once every 12 months.
6/1999: Interim policy revision: Included use of quantitative ultrasound (QUS) as an approved method.
8/1999: Addition of QUS approved by MPAC.
11/2000: Reviewed by MPAC; no changes.
5/21/2001: Code Reference section revised; non-covered codes table added.
10/15/2001: Verbiage revised under "policy" section; "Reimbursement is not provided for SPA, DPA or QCT bone densitometry techniques" to "SPA, DPA and QCT bone densitometry techniques are considered investigational and not eligible for coverage."
2/14/2002: Investigational definition added.
4/18/2002: Type of Service and Place of Service deleted.
6/12/2002: ICD-9 diagnosis codes 493 and 579 4th/5th digit added.
3/2003: Reviewed by MPAC, frequency of all current indications changed to every 2 years except long term glucocorticoid therapy where bone density substantiates need for glucocorticoid reduction remains every 12 months, Sources updated.
6/12/2003: Code Reference section updated.
8/7/2003: Code Reference section updated, CPT code range 76075-76076 listed separately, fourth and fifth digit added as appropriate to 242.9, 256.3, and 556, ICD-9 diagnosis code ranges listed separately 493.00-493.92, 555.0-555.9, 579.0-579.9, 756.5-756.59, ICD-9 diagnosis codes 491.20 and 491.21 complete descriptions added.
8/14/2003: CPT code 76071 added, ICD-9 diagnosis codes 227.3, V07.4 added.
7/14/2004: Code Reference section updated, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6. 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 deleted.
9/27/2004: Under Policy “chronic” renal failure specified, ICD-9 diagnosis code 491.20, 491.21, 493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.90, 493.91, 493.92, 496, 555.0, 555.1, 555.2, 555.9, 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9, 558.9, 564.2, 571.49, 714.0 added to covered codes with notation “Bone density measurement, using either the QUS or DEXA technology is considered medically necessary and eligible for coverage once every 12 months for long term glucocorticoid therapy where bone density substantiates a need for glucocorticoid reduction in conditions such as listed above but not limited to the condition above. Note: V58.65 Long-term (current) use of steroids,” The examples of conditions listed are covered in addition to other chronic illnesses requiring the long term (current) use of glucocorticoid. Note “but not limited to” - coding has been listed in the Code Reference section for the examples listed in the Policy section only, ICD-9 diagnosis code 242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 756.10, 756.9 added to covered codes, ICD-9 diagnosis code 252.0 5th digit added “252.01,” ICD-9 diagnosis code 626.0 note added “Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa (ICD-9 diagnosis code 307.1).
3/24/2005: CPT code 76077 with effective date of 1/1/2005 added.
8/26/2005: CPT code 76077 deleted.
11/8/2005: Code Reference section updated, 4th digit added to ICD9 diagnosis code 585.1-585.9: description revised.
03/10/2006: Coding updated. HCPCS 2006 revisions added to policy.
09/13/2006: Coding updated. ICD9 2006 revisions added to policy.
09/25/2006: Policy clarified and partially rewritten.
10/25/2006: Code reference section updated. CPT code 76077 added to covered table. HCPC code G0130 added to non-covered table.
12/21/2006: Policy clarified. Added "including, but not limited to, women 60 years of age or older" to women deficient in estrogen following menopause.
12/28/2006: Code Reference section updated per the 2007 CPT/HCPCS revisions.
12/17/2007: Coding updated. CPT/HCPCS 2008 revisions added to policy.
9/17/2008: Annual ICD-9 updates effective 10-1-2008 applied.
9/28/2009: Code reference section updated. New ICD-9 diagnosis code 569.71 added to covered table. CPT codes 76075 and 76076 deleted from covered table due to codes were deleted as of 12-31-2006. HCPC code Q9952 deleted from covered table due to code was deleted as of 12-31-2007.
12/22/2009: Title revised to include “Mineral.” Description Section updated to add Quantitative Computed Tomography (QCT) and Ultrasound Densitometry, removed Quantitative Ultrasound. Policy Statement Section totally revised to include: screening for osteoporosis covered once for women at age 50 as part of Healthy You! Wellness benefit, changed criteria of when initial measurements may be considered medically necessary, added World Health Organization (WHO) Risk Assessment Model; changed criteria for repeat measurements with specific interval guidelines; added criteria for serial measurements to monitor treatment response with specific interval guidelines. Code reference section updated. CPT codes 76499, 77078, 77079 and 77082 were added to covered table. CPT Codes 77083, 78350 and 78351 were moved from non-covered to covered table. Removed deleted code Q9952 from the covered table. ICD-9 diagnosis code range 250.01-250.93, 252.00, 252.02, 252.08, 253.1, 263.8, 263.9, 307.1, 307.51, 493.81, 493.82, 571.0-571.9 code range, 714.1-714.9 code range, 733.10-733.19 code range, V82.81 and V85.0 added to covered table. ICD-9 diagnosis codes V86.0 and V86.1 deleted from covered table. Non-covered table deleted.
09/07/2010: Added policy statement regarding aromatase inhibitors to indicate that serial measurements to monitor bone density for individuals on aromatase inhibitors may be considered medically necessary not more frequent than every 2-3 years when the information will affect treatment decisions.
11/08/2010: Added ICD-9 code V07.52 to the Covered Codes table.
09/14/2011: Added the following verbiage to the Policy Exceptions section: State Health Plan (State and School Employees): Bone density studies are covered for women once every 2 years beginning at age 60 under the Plan's wellness benefits.
03/27/2012: Policy reviewed; no changes.
07/19/2013: Policy reviewed; no changes.
07/11/2014: Policy reviewed; no changes.
12/31/2014: Added the following new 2015 CPT codes to the Code Reference section: 77085 and 77086.
07/10/2015: Policy reviewed; no changes.
08/26/2015: Medical policy revised to add ICD-10 codes. Removed deleted CPT code 77079 and ICD-9 procedure code 88.98 from the Code Reference section.
01/01/2016: Policy statement updated to change the once per lifetime general osteoporosis screening for women from age 50 to 65 under the Healthy You! Wellness benefit. Removed deleted code CPT code 77082.
06/08/2016: Policy number L.6.01.412 added. Policy Guidelines updated to add medically necessary definition.
05/04/2017: Code Reference section updated to correct invalid ICD-10 diagnosis code: K76.8 should be K76.81.
08/17/2017: Policy section updated to include "Long-term use of anticonvulsant/antiepileptic medications" as a risk factor according to the World Health Organization (WHO) Fracture Risk Assessment Model.
09/29/2017: Code Reference section updated to revise descriptions for ICD-10 diagnosis codes Z68.1 and Z79.890. Effective 10/01/2017.
01/18/2019: Policy exceptions updated to add the following for Hancock Whitney Corporation: Under Healthy You! benefits, bone density screening is covered for men and women once per calendar year beginning at age 60, and for women under age 60 who are at increased fracture risk.
09/29/2020: Code Reference section updated to add new ICD-10 diagnosis codes K74.00, K74.01, K74.02, N18.30, N18.31, N18.32, M08.9A, M80.0AXA, M80.0AXD, M80.0AXG, M80.0AXK, M80.0AXP, M80.0AXS, M80.8AXD, M80.8AXG, M80.8AXK, M80.8AXP, and M80.8AXS, effective 10/01/2020. Revised code description for ICD-10 diagnosis code Z68.1.
12/15/2021: Code Reference section updated to add new CPT codes 77089, 77090, 77091, and 77092, effective 01/01/2022. Removed deleted ICD-10 diagnosis code K74.0.
10/10/2022: Policy reviewed. Policy statements unchanged. Policy Guidelines updated to change "Nervous/Mental Conditions" to "Mental Health Disorders" and "Medically Necessary" to "medical necessity."
08/22/2023: Policy reviewed; no changes.
09/29/2023: Code Reference section updated to add new ICD-10 diagnosis codes K90.821, K90.822, K90.829, K90.83, M80.0B1A, M80.0B1D, M80.0B1G, M80.0B1K, M80.0B1P, M80.0B1S, M80.0B2A, M80.0B2D, M80.0B2G, M80.0B2K, M80.0B2P, M80.0B2S, M80.0B9A, M80.0B9D, M80.0B9G, M80.0B9K, M80.0B9P, M80.0B9S, M80.8B1A, M80.8B1D, M80.8B1G, M80.8B1K, M80.8B1P, M80.8B1S, M80.8B2A, M80.8B2D, M80.8B2G, M80.8B2K, M80.8B2P, M80.8B2S, M80.8B9A, M80.8B9D, M80.8B9G, M80.8B9K, M80.8B9P, and M80.8B9S, effective 10/01/2023.
08/29/2024: Policy reviewed. Policy statements unchanged. Policy Exceptions updated to remove Hancock Whitney Corporation.
10/01/2024: Code Reference section updated to add new ICD-10 diagnosis codes F50.010, F50.011, F50.012, F50.013, F50.014, F50.019, F50.020, F50.021, F50.022, F50.023, F50.024, F50.029, F50.20, F50.21, F50.22, F50.23, F50.24, and F50.25.
Aromatase inhibitors Prescribing Information
Blue Cross Blue Shield Association policy # 6.01.01
Bone Densitometry Medical Policy established by the Blue Cross Blue Shield Association and nationally affiliated plans.
Hayes Medical Technology Directory
Heidi D. Nelson, M.D., M.P.H., Mark Helfand, M.D., M.P.H., Steven H. Woolf, M.D., M.P.H., Janet D. Allan, P.H.D., R.N., Screening for Postmenopausal Osteoporosis
Medicare Program Memorandum Transmittal No. AB-98-32
Task Force Urges Routine Osteoporosis Screening for Women 65 and Older to Identify Those at Risk for Fracture, Press Release Date: September 16, 2002 (added 3/2003)
TEC Evaluations 1987: p. 307; 1993: Tab 2
U.S. Preventive Services Task Force Recommendations: Osteoporosis Screening
U.S. Preventive Services Task Force Recommendations: Screening for Osteoporosis in Postmenopausal Women
This may not be a comprehensive list of procedure codes applicable to this policy.
The code(s) listed below are ONLY medically necessary if the procedure is performed according to the "Policy" section of this document.
Code Number | Description | ||
CPT-4 | |||
76499 | Unlisted diagnostic radiographic procedure | ||
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, bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine) | ||
77081 | Dual-energy X-ray absorptiometry, bone density study, 1 or more sites; appendicular skeleton | ||
77083 | Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), 1 or more sites | ||
77085 | Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine), including vertebral fracture assessment | ||
77086 | Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) | ||
77089 | Trabecular bone score (TBS), structural condition of the bone microarchitecture; using dual X-ray absorptiometry (DXA) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk | ||
77090 | Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission of data for analysis to be performed elsewhere | ||
77091 | Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only | ||
77092 | Trabecular bone score (TBS), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional | ||
78350 | Bone density study, one or more sites; single photon absorptiometry | ||
78351 | Bone density study, one or more sites; dual photon absorptiometry | ||
HCPCS | |||
A9579 | Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified | ||
ICD-9 Procedure | ICD-10 Procedure | ||
ICD-9 Diagnosis | ICD-10 Diagnosis | ||
227.3 | Benign neoplasm of pituitary gland (prolactinoma) | D35.2, D35.3 | Benign neoplasm of pituitary gland and craniopharyngeal duct |
242.00, 242.01, 242.10, 242.11, 242.20, 242.21, 242.30, 242.31, 242.40, 242.41, 242.80, 242.81, 242.90, 242.91 | Thyrotoxicosis (hyperthyroidism) code range | E05.00 - E05.91 | Thyrotoxicosis (hyperthyroidism) (code range) |
250.01, 250.03, 250.11, 250.13, 250.21, 250.23, 250.31, 250.33, 250.41, 250.43, 250.51, 250.53, 250.61, 250.63, 250.71, 250.73, 250.81, 250.83, 250.91, 250.93 | Diabetes (type I insulin dependent) code range | E10.10 - E10.9 | Diabetes (type I insulin dependent) (code range) |
252.00, 252.01, 252.02, 252.08 | Hyperparathyroidism code range | E21.0 - E21.3 | Hyperparathyroidism (code range) |
253.1 | Other and unspecified anterior pituitary hyperfunction (hyperprolactinemia) | E22.1, E22.8, E22.9 | Hyperfunction of pituitary gland |
255.0 | Cushings Syndrome | E24.0 - E24.9 | Cushings Syndrome (code range) |
256.2 | Post ablative ovarian failure (post surgical menopause) | E89.40, E89.41 | Postprocedural ovarian failure |
256.31,256.39 | Other ovarian failure code range | E28.310 - E28.9 | Primary ovarian failure (code range) |
257.2 | Other testicular hypofunction (testicular hypogonadism | E29.1 | Testicular hypofunction |
258.9 | Polyglandular dysfunction, unspecified | E31.9 | Polyglandular dysfunction, unspecified |
263.8 | Other protein-calorie malnutrition | E46 | Unspecified protein-calorie malnutrition |
263.9 | Unspecified protein-calorie malnutrition | E64.0 | Sequelae of protein-calorie malnutrition |
275.5 | Hungry bone syndrome | E83.81 | Hungry bone syndrome |
307.1 | Anorexia nervosa | F50.00 - F50.029 | Anorexia nervosa (code range) (F50.010, F50.011, F50.012, F50.013, F50.014, F50.019, F50.020, F50.021, F50.022, F50.023, F50.024, F50.029 New 10/01/2024) |
307.51 | Bulimia nervosa | F50.2 | Bulimia nervosa (Deleted 09/30/2024) |
F50.20, F50.21, F50.22, F50.23, F50.24, F50.25 | Bulimia nervosa (New 10/01/2024) | ||
491.20 | Obstructive chronic bronchitis, without exacerbationNote: Code first V58.65 Long-term (current) use of steroids | J44.9 | Chronic obstruction pulmonary disease, unspecified |
491.21 | Obstructive chronic bronchitis, with (acute) exacerbationNote: Code first V58.65 Long-term (current) use of steroids | J44.1 | Chronic obstructive pulmonary disease, with (acute) exacerbation |
493.00,493.01 493.02,493.10, 493.11,493.12, 493.20,493.21, 493.22,493.81, 493.82,493.90, 493.91,493.92 | Asthma code rangeNote: Code first V58.65 Long-term (current) use of steroids | J44.0 - J45.998 | Other chronic obstructive pulmonary disease (code range) |
496 | Chronic airway obstruction, not elsewhere classified Note: Code first V58.65 Long-term (current) use of steroids | J44.9 | Chronic obstruction pulmonary disease, unspecified |
538 | Gastrointestinal mucositis (ulcerative) | K92.81 | Gastrointestinal mucositis (ulcerative) |
555.0, 555.1, 555.2,555.9 | Regional enteritis code rangeNote: Code first V58.65 Long-term (current) use of steroids | K50.00 - K50.919 | Regional enteritis (code range) |
556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8,556.9 | Ulcerative colitis code rangeNote: Code first V58.65 Long-term (current) use of steroids | K51.00 - K51.919 | Ulcerative colitis (code range) |
558.9 | Other and unspecified noninfectious gastroenteritis and colitis (Inflammatory bowel disease) Note: Code first V58.65 Long-term (current) use of steroids | K52.89, K52.9 | Other and unspecified noninfectious gastroenteritis and colitis (Inflammatory bowel disease) |
564.2 | Post-gastrectomy syndrome Note: Code first V58.65 Long-term (current) use of steroids | K91.1 | Postgastric surgery syndromes |
569.71 | Pouchitis | K91.850 | Pouchitis |
571.0 – 571.9 | Chronic liver disease code range | K70.0 - K70.41 | Alcoholic liver disease (code range) |
K73.0 - K73.9 | Chronic hepatitis, not elsewhere classified (code range) | ||
K74.00 - K74.69, K74.00, K74.01, K74.02 | Fibrosis and cirrhosis of liver (code range) | ||
K75.4 | Autoimmune hepatitis | ||
K75.81 | Nonalcoholic steatohepatitis (NASH) | ||
K76.0, K76.81, K76.89, K76.9 | Other diseases of liver | ||
579.0, 579.1, 579.2, 579.3, 579.4, 579.8,579.9 | Intestinal malabsorption code range | K90.0 - K90.9 | Intestinal malabsorption (code range) |
K91.2 | Postsurgical malabsorption, not elsewhere classified | ||
585.1, 585.2, 585.3, 585.4, 585.5, 585.6,585.9 | Chronic kidney disease code range | N18.1 - N18.9, N18.30, N18.31, N18.32 | Chronic kidney disease (code range) |
626.0 | Absence of menstruation Note: Amenorrhea of six month's duration associated with extensive exercise and/or anorexia nervosa [ICD-9 diagnosis code 307.1] | N91.0 - N91.2 | Absent, scanty and rare menstruation (code range) |
627.2 | Menopausal or female climacteric state | N95.1 | Menopausal and female climacteric state |
627.4 | States associated with artificial menopause | N95.8 | Other specified menopausal and perimenopausal disorders |
627.8 | Other specified menopausal and post menopausal disorder | N95.8 | Other specified menopausal and perimenopausal disorders |
627.9 | Unspecified menopausal and post menopausal disorder | N95.9 | Unspecified menopausal and perimenopausal disorder |
714.0,714.1, 714.2, 714.30, 714.31, 714.32, 714.33, 714.4, 714.81, 714.89, 714.9 | Rheumatoid arthritis and other inflammatory polyarthropathies Note: Code first V58.65 Long-term (current) use of steroids | M05.00 - M08.99, M08.9A | Rheumatoid arthritis and other inflammatory polyarthropathies (code range) |
M12.00 - M12.09 | Chronic postrheumatic arthropathy (Jaccoud's syndrome) (code range) | ||
733.00, 733.01, 733.02, 733.03, 733.09 | Osteoporosis code range | M81.0 - M81.8 | Osteoporosis without current pathological fracture (code range) |
733.10, 733.11, 733.12, 733.13, 733.14, 733.15, 733.16, 733.19 | Pathologic fracture code range | M48.50XA - M48.58XS | Collapsed vertebra, not elsewhere classified (code range) |
M80.00XA - M80.88XS, M80.0AXA, M80.0AXD, M80.0AXG, M80.0AXK, M80.0AXP, M80.0AXS, M80.8AXD, M80.8AXG, M80.8AXK, M80.8AXP, M80.8AXS, M80.0B1A, M80.0B1D, M80.0B1G, M80.0B1K, M80.0B1P, M80.0B1S, M80.0B2A, M80.0B2D, M80.0B2G, M80.0B2K, M80.0B2P, M80.0B2S, M80.0B9A, M80.0B9D, M80.0B9G, M80.0B9K, M80.0B9P, M80.0B9S, M80.8B1A, M80.8B1D, M80.8B1G, M80.8B1K, M80.8B1P, M80.8B1S, M80.8B2A, M80.8B2D, M80.8B2G, M80.8B2K, M80.8B2P, M80.8B2S, M80.8B9A, M80.8B9D, M80.8B9G, M80.8B9K, M80.8B9P, M80.8B9S | Osteoporosis with current pathological fracture (code range) | ||
M84.40XA - M84.48XS | Pathological fracture, not elsewhere classified (code range) | ||
M84.50XA - M84.58XS | Pathological fracture in neoplastic disease (code range) | ||
M84.60XA - M84.68XS | Pathological fracture in other disease (code range) | ||
733.7 | Algoneurodystrophy (disuse atrophy of bone) | M89.00 - M89.09 | Algoneurodystrophy (disuse atrophy of bone) (code range) |
733.90 | Disorder of Bone and Cartilage, unspecified (Osteopenia) | M85.9 | Disorder of bone density and structure, unspecified |
M89.9 | Disorder of bone, unspecified | ||
M94.9 | Disorder of cartilage, unspecified | ||
756.10 | Congenital anomaly of spine, unspecified | Q76.49 | Other congenital malformations of spine, not associated with scoliosis |
756.50, 756.51, 756.52, 756.53, 756.54, 756.55, 756.56, 756.59 | Osteodystrophies code range See POLICY | Q77.3, Q77.6 | Osteochondrodysplasia with defects of growth of tubular bones and spine |
Q78.0 - Q78.9 | Other osteochondrodysplasias (code range) | ||
756.9 | Other and unspecified congenital anomaly of musculoskeletal system (anomaly bone) | Q68.8 | Other specified congenital musculoskeletal deformities |
Q79.8, Q79.9 | Other and unspecified congenital malformations of musculoskeletal system | ||
V07.4 | Need for prophylactic postmenopausal hormone replacement therapy | Z79.890 | Hormone replacement therapy |
V49.81 | Asymptomatic post menopausal status (age related) (natural) | Z78.0 | Asymptomatic menopausal state |
V58.65 | Long-term (current) use of steroids | Z79.51, Z79.52 | Long-term (current) use of steroids |
V58.69 | Encounter for long-term (current) use of other medications (Anticonvulsant therapy with dilantin or Phenobarbital for more than 5 years) | Z79.891, Z79.899 | Other long term (current) drug therapy |
V07.52 | Use of aromatase inhibitors | Z79.811 | Long-term (current) use of aromatase inhibitors |
V82.81 | Screening for Osteoporosis | Z13.820 | Encounter for screening for osteoporosis |
V85.0 | Body Mass Index less than 19, adult | Z68.1 | Body mass index [BMI] 19.9 or less, adult |
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