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What is the procedure code or CPT code for DEXA scan with TBS?
I have been diagnosed with osteopenia two years ago and is scheduled to have a DEXA scan this year. After reading all the comments, I have decided to go with DEXA scan with TBS. Unfortunately, my insurance does not cover it. I have Medicare Advantage PPO. I called the hospital to get an estimate for self-pay and was informed they needed the CPT code. I had my annual physical exam yesterday and had asked my PCP for the code but she gently excused herself from the room. My endocrinologist only orders the DEXA scan. Any information is greatly appreciated. Thanks!
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77089 trabecular bone score Is the dxa being paid by the Advantage Plan? The TBS is from software used during the DXA. Many places don't have the software. I think the hospital charge for cash patients is going to be more that a radiology center.
77080 for the DXA
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1 ReactionWow I am requesting this from
My integrative medicine doctor. Also the endro never discussed C Telopepyide bloodwork. I investigated my scores and the highest was 800 ten years ago, Now 320 which shows the turnover is much less. If anyone knows about these numbers I would love to discuss.
There are four CPT codes for TBS, and which one will be used very much depends on the setting in which you will received the exam.
In a physician office or an imaging center, usually they will use 77089.
But in a hospital, oftentimes they use what is called "provider-based billing", which means that there will be two separate bills, one for paying the hospital itself, and one for paying the physician who interprets the results.
In these cases, usually the hospital will bill 77091, and the physician separately bills 77092, which is for the interpretation only.
Most of the cost will be for 77091 normally, so you should be able to ask them the price for this code.
This is for TBS only, to which you should add the DXA cost.
Keep in mind hospitals will usually be (much) more expensive than an independent imaging center.
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4 ReactionsI have been charged for both the 77080 DX Scan and then for the 77089 TBS. I was informed by billing that the 77089 is necessary to read the scan 77080, but my insurance is denying this later portion of the scan as it would be considered investigational. How is 77089 investigational if it is used for the initial order? Is there another code that should be used instead - the scan was for a fracture not investigational. Thank you for the input.
Dexa billing code for vertebral fracture it's 77985. I'm not sure if that will resolve the TBS coverage. Many insurers cover TBS under the Medical Necessity Form that you physician might need to fill out. Some insurers still don't cover TBS. Some make us appeal every thing they can. They make money because most people don't appeal.
On the other hand I don't think that you've been given correct information about whether the Dexa portion can be read without the TBS portion.