Does 76977 require prior authorization?

No, 76977 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 76977?

Medicare facility rate: $3.00. Non-facility rate: $3.00. Work RVU: 0.05.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

0.05

Facility

$3.00

Non-Facility

$3.00

All services ordered or rendered to Medicare beneficiaries must be signed; providers/suppliers must notify beneficiaries in writing prior to rendering the service if aware the test/item/procedure may not be covered.
A valid ICD-10-CM diagnosis code that best describes the patient's condition must be reported on the claim; claims without a valid ICD-10-CM code will be returned as incomplete under Section 1833(e).
For services requiring a referring/ordering physician, the name and NPI of the referring/ordering physician must be reported on the claim.
The patient's medical record must include the ordering provider's assessment related to the visit complaint, relevant medical history, results of pertinent tests/procedures, and a signed and dated office visit record or operative report.

Bone mass measurement tests are covered when ordered by the treating physician or a qualified non-physician practitioner authorized by state law.
An initial bone mass measurement is covered (Medicare reimbursement for an initial bone mass measurement may be allowed only once, regardless of sites studied).
A DXA confirmatory test may be performed and covered as a baseline for future monitoring (exception to the 'one type only' rule).
CPT code 77082 (vertebral fracture assessment) is covered when medically necessary, with symptoms documented and when results are anticipated to be used in patient management.
Bone mass measurement services are covered when they meet the clinical indications and medical necessity criteria specified in the related Local Coverage Determination L39268.
Perform peripheral venous ultrasound to evaluate clinical signs or symptoms suggestive of acute or new-onset deep vein thrombosis (e.g., extremity swelling, tenderness, erythema).

L33693 — Peripheral Venous Ultrasound

J09

L37371 — Electroretinography (ERG)

J12

A53252 — Billing and Coding: Independent Diagnostic Testing Facility (IDTF)

J12

L35007 — Vestibular and Audiologic Function Studies

J12

L35434 — Oximetry Services

Ask Verity about documentation requirements, denial risks, or coverage in your state.