An overview of Osteoporosis
Osteoporosis is a medical condition in which the bones become brittle and fragile or weak from loss of tissue as a result of hormonal changes, or deficiency of calcium or vitamin D.It is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone. This disorder of the skeleton weakens the bone and results in frequent fractures in the bones.
Symptoms of Osteoporosis:
? Osteoporosis can be present without any symptoms because it doesn’t cause any symptoms until bone fractures.
? The symptom associated with osteoporotic fractures usually is pain though the location of the pain depends on the location of the fracture.
? The symptoms of osteoporosis in men are similar to the symptoms of osteoporosis in women.
Risk factors :
? Aging,
? Being female
? Low body weight
? Low sex hormones or menopause
? Smoking, and some medications
Prevention and treatment:
? Calcium and Vitamin D
? Exercise
? Osteoporosis medications
From the coding prospective, there are certain points to be taken into consideration:
Body Mass Measurement (BMM) is a Preventive Service:
1. Medicare provides the coverage and payment for bone mass measurement (BMM) screening for identifying bone mass, detect bone loss, or determine bone quality once every two years only if medically necessary.
2. The copayment/coinsurance and deductible are waived, because Body Mass Measurement screening is a preventive service.
Procedure Codes Reflect New Technology
Single and dual photon absorptiometry are no longer being used and, as such, CPT(R) codes 78350 and 78351 have been deleted for 2015 reporting.
CPT(R) bone mass procedure codes payable under Medicare are:
? Ultrasound bone density measurement and interpretation, peripheral site(s), any method 76977
? Computed tomography, bone mineral density study, 1 or more sites; axial skeleton (Eg, hips, pelvis, spine) 77078
? Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (Eg, hips, pelvis, spine) 77080
? Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (Eg, radius, wrist, heel) 77081
? Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (Eg, hips, pelvis, spine), including vertebral fracture assessment 77085
? Vertebral fracture assessment via dual-energy X-ray absorptiometry (DXA) 77086
? Single energy X-ray absorptiometry (Sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (Eg, radius, wrist, heel) G0130
Payment On Diagnosis and Medical Necessity
? ICD-9-CM diagnosis coding was dependent on the procedure being reported. For example, ICD-9-CM codes that support 77080 include 733.0, 733.01, 733.02, 733.03, 733.09, 733.90, V58.65, V58.68, V58.69, and 255.0. For the remaining procedure codes listed above, acceptable diagnoses include: 252.01, 256.2, 256.31, 627.1, 627.2, 627.3, 627.4, 627.8, 733.13, 805,00-805.7, 806.00-806.79, V49.81, V58.65, and V58.69
? A patient must meet at least one of five conditions:
1. Estrogen-deficient
2. Vertebral abnormality
3. Steroid treatment
4. Hyperparathyroidism
5. Osteoporosis drug therapy monitoring for a Body Mass Measurement study to be covere