Billing and Coding: Bone Mass Measurement

Bone mass measurement is covered when ordered by the treating physician or qualified non-physician practitioner; an initial BMM is reimbursable only once and additional testing is limited except for DXA confirmatory testing used as a baseline for monitoring. CPT 77082 is limited to vertebral fracture assessment (not screening); single and dual photon absorptiometry (CPT 78350/78351) and portable x-ray BMM are non-covered, and tests without a separate interpretation/report will be denied. Claims must include a valid ICD-10-CM code, ordering provider name/NPI when required, and adhere to ABN/modifier (GA/GX/GY/GZ) and documentation requirements (including CMS-R-131 and occurrence code 32 for Part A where applicable).

"Bone mass measurement tests are covered when ordered by the treating physician or a qualified non-physician practitioner authorized by state law."