Don’t let 2006 DXA code references lead you to use wrong codes.
Which codes should you use to reap the benefit of CMS’s new calculations for bone scan payment? During an April 13 CMS Open Door Forum, that’s what one caller wanted to know.
Good news: He was delighted that, thanks to the new healthcare reform legislation, CMS will be raising payment for bone density tests, but noted that the legislation listed old bone density test codes 76075 and 76077. The caller asked whether MACs will be requesting those old codes going forward, or whether practices should continue reporting current codes 77080-77082 (Dual-energy X-ray absorptiometry [DXA] …).
Advice: You should use current codes 77080-77082, not the old codes, said CMS’s Amy Bassano.
Added support: CMS transmittal 700, effective Jan. 1 and implemented June 1, announces increased payment for DXA scan imaging, making the new non-facility total relative value units (RVUs) 2.70. The original 2010 fee schedule listed the transitioned non-facility total RVUs for this code as 1.71.
When combined with the conversion factor of $36.0791, that makes DXA pay about $97.00, a $36.00 increase over the previous payment of approximately $61.00. The calculation for the new rates depended on 2006 values, which is why the now-deleted codes are referenced. The transmittal notes that 77080 and 77082 replaced the 2006 codes.
@ Optometry Coding Alert (Editor: Jerry Salley, CPC).
Sign up for the upcoming live audio conference, Risk Management Strategies for Healthcare Providers, or order the CD/transcripts.
- Free updates on CPT, ICD-9, HCPCS, Medicare, NCCI edits, and ICD-10.
- Discounts on 3rd party offers