Billing and Coding: Bone Mass Measurement

This billing and coding guidance complements LCD L39268 for bone mass measurement: follow the LCD for clinical indications and frequency limits. Claims must comply with NCCI and OPPS edits, include the referring/ordering physician name and NPI when required, and bundle same-day services on a single claim; venography performed during an operative session is not separately billable. Medical records must fully document medical necessity, including history, physical exam, and pertinent test results.

"Bone mass measurement services are covered when they meet the clinical indications and medical necessity criteria specified in the related Local Coverage Determination L39268."

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