About this policy
The information in this article contains billing, coding or other guidelines that complement the Local Coverage Determination (LCD) for Bone Mass Measurement L39268. Coding Guidelines Procedure codes may be subject to National Correct Coding Initiative (NCCI) edits or Outpatient Prospective Payment System (OPPS) packaging edits. Refer to NCCI and OPPS requirements prior to billing Medicare. For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim. All services/procedures performed on the same day for the same beneficiary by the physician/provider should be billed on the same claim. Specific Coding Guidelines No separate payment for venography performed during the operative session may be allowed and it should not be separately billed. Documentation Requirements The patient's medical record must contain documentation that fully supports the medical necessity for services included within the related LCD. (See "Indications and Limitations of Coverage.") This documentation includes, but is not limited to, relevant medical history, physical examination, and results of pertinent diagnostic tests or procedures.
Codes in this policy
Code numbers and each code’s status as the policy records it. CPT code descriptions are left out of this page, as are the passages that cite CPT codes; the official document has them.
| Code | Code system | Status in this policy |
|---|---|---|
| 0554T | HCPCS | Covered |
| 0555T | HCPCS | Covered |
| 0556T | HCPCS | Covered |
| 0557T | HCPCS | Covered |
| 0558T | HCPCS | Covered |
| 76977 | HCPCS | Covered |
| 77078 | HCPCS | Covered |
| 77080 | HCPCS | Covered |
| 77081 | HCPCS | Covered |
| 77085 | HCPCS | Covered |
| 78350 | HCPCS | Covered |
| 78351 | HCPCS | Covered |
| G0130 |