Wiki Trabecular Bone Score

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hcorum@rana-hsv.org

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We are billing 77089 and 77080.GA (Bone Density) but we cannot get payment from BCBS. They keep denying the 77089 saying non covered. We tried adding a .59 modifier to the 77089 and we are getting the same denial. Medicare is paying these with no problems. We are a specialist office and we do these in house.
 
According to MVP healthcare https://www.mvphealthcare.com/-/med...023/2023-23-updated-trabecular-bone-scans.pdf
"...CPT codes 77089, 77090, 77091, and 77092 for Trabecular Bone Scans will no longer receive separate paymentbecause they are incidental to the Bone Density Studies using central and peripheral dual-energy X-rayabsorptiometry (DXA) CPT codes 77080, 77081, and 77085 used for the DXA scan.This will apply to all MVP Commercial plans, Medicare Advantage plans, and Medicaid Managed Care plans..."
Also, according to updated in October 2024 BCBS guidelines, valid indications - PDXs- should be billed for both CPTs https://www.bcbsnd.com/providers/po...medical-policy/b/bone-mineral-density-studies
 
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