ICD-10 Coding for Peripheral DEXA Scan(M81.0, Z13.820)
Complete ICD-10-CM coding and documentation guide for Peripheral DEXA Scan. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Peripheral DEXA Scan
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M81.0 | Osteoporosis without current pathological fracture | Use when diagnosing osteoporosis without fractures, especially in postmenopausal women. |
|
| Z13.820 | Encounter for screening for osteoporosis | Use for preventive screening encounters without a confirmed diagnosis. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: What is CPT code 77081?
Essential facts and insights about Peripheral DEXA Scan
Primary ICD-10-CM Codes for that cover 77081
Decision Criteria
clinical Criteria
- Patient is postmenopausal with a T-score ≤ -2.5.
coding Criteria
- No current fractures present.
Applicable To
- Senile osteoporosis
- Postmenopausal osteoporosis
Excludes
- Osteoporosis with current pathological fracture (M80.-)
Clinical Validation Requirements
- T-score ≤ -2.5
- Postmenopausal status
- Age > 65
Code-Specific Risks
- Incorrectly coding for patients with fractures.
Coding Notes
- Ensure documentation specifies no current fractures.
Z13.820 - Encounter for screening for osteoporosis
Use for preventive screening encounters without a confirmed diagnosis.
Applicable To
- Screening for osteoporosis
Excludes
- Diagnostic tests for osteoporosis (M81.0)
Clinical Validation Requirements
- Routine screening in postmenopausal women
- Family history of osteoporosis
Coding Notes
Ensure documentation reflects screening intent.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for screening for osteoporosis
Z13.820Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Peripheral DEXA Scan to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M81.0.
Impact
Clinical: Inaccurate assessment of osteoporosis risk., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Use specific language detailing the site and reason for the test.
Impact
Reimbursement: Claims may be denied if incorrect site is billed., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on bone density testing.
Mitigation Strategy
Use 77080 for axial sites.
Impact
Reimbursement: Denial of claims due to NCCI edits., Compliance: Failure to adhere to Medicare billing rules., Data Quality: Incorrect billing data affecting audits.
Mitigation Strategy
Append modifier XU to 77080 for Medicare claims.
Impact
Failure to use modifier XU when required.
Mitigation Strategy
Educate billing staff on correct modifier application.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Peripheral DEXA Scan, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Peripheral DEXA Scan
Use these documentation templates to ensure complete and accurate documentation for Peripheral DEXA Scan. These templates include all required elements for proper coding and billing.
Screening for osteoporosis in postmenopausal women
Specialty: OrthopedicsRequired Elements
- Patient demographics
- Reason for test
- Sites scanned
- Findings
- ICD-10 codes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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