Health Information Management

Tip of the Week: Watch for inappropriate denials of bone mass measurement claims

APCs Insider, December 21, 2007

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CMS announced that some Medicare contractors have inappropriately denied hospital claims for bone mass measurements due to the contractors' misinterpretation of recent CMS transmittals. The relevant CPT code is 77080 (Dual-energy x-ray absorptiometry [DXA] bone density study, one or more sites; axial skeleton [e.g., hips, pelvis, spine]). CMS explained that it has brought the problem to the contractors' attention, and that the contractors are making the necessary system changes to properly pay claims that include CPT code 77080.

Resources: View CMS Transmittals 69, 70, and 1236 for more information.

(The above tip was excerpted from the December issue of Briefings on APCs).

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