How To Use CPT Code 0547T

CPT 0547T describes the procedure for bone-material quality testing by microindentation of the tibia, with the results reported as a score. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0547T?

CPT 0547T can be used to report bone-material quality testing by microindentation of the tibia. This procedure assesses the stiffness and toughness of the bone, providing valuable information for joint replacement surgery and evaluating fracture potential in patients with osteoporosis or osteopenia. The results of the test are reported as a score.

2. Official Description

The official description of CPT code 0547T is: ‘Bone-material quality testing by microindentation(s) of the tibia(s), with results reported as a score.’

3. Procedure

1. The provider prepares the patient and administers local anesthesia.
2. A reference point indenter is inserted through the skin into the shaft of the tibia.
3. The provider activates the instrument, which produces a microfracture on the cortical surface of the bone.
4. Indentation force and depth are measured, and multiple indentations are made 1 to 2 mm apart.
5. The results are relayed through the probe to a computer, which interprets the data using an algorithm and reports the bone material strength index as a score.

4. Qualifying circumstances

CPT 0547T is used for patients who require bone-material quality testing of the tibia. This procedure is particularly useful for individuals with osteoporosis or osteopenia, as well as those undergoing joint replacement surgery. The test assesses the bone’s stiffness and toughness, providing important information for treatment planning and evaluating fracture risk.

5. When to use CPT code 0547T

CPT code 0547T should be used when performing bone-material quality testing by microindentation of the tibia. It is important to note that this code is specific to the tibia and should not be used for testing other bones or locations. If the procedure involves the insertion, removal, or adjustment of a periurethral adjustable balloon continence device, different codes should be used.

6. Documentation requirements

To support a claim for CPT 0547T, the provider must document the following information:

• Patient’s diagnosis or indication for the bone-material quality testing
• Details of the procedure, including the use of local anesthesia
• Date and time of the test
• Results of the microindentation, reported as a score
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 0547T, ensure that the procedure involves bone-material quality testing of the tibia. It is important to follow the specific guidelines for reporting this code and to verify coverage with the payer, as it may be considered investigational or not yet approved by the FDA. If the procedure is not payable, it should still be coded and reported for tracking purposes.

8. Historical information

CPT 0547T was added to the Current Procedural Terminology system as a Category III code. Category III codes are temporary codes used to collect information about investigational technologies and procedures. The inclusion of a Category III code does not imply agreement concerning efficacy, safety, or appropriateness of the procedure to clinical practice or payer reimbursement.

9. Examples

1. A patient with osteoporosis undergoes bone-material quality testing of the tibia to assess fracture potential.
2. A candidate for joint replacement surgery undergoes microindentation of the tibia to evaluate bone quality.
3. A postmenopausal woman with osteopenia undergoes bone-material quality testing to monitor her bone health.
4. A patient with a history of fractures undergoes tibial microindentation to assess bone strength.
5. An athlete with a stress fracture undergoes bone-material quality testing of the tibia to guide treatment and rehabilitation.
6. A patient with osteoporosis receives regular bone-material quality testing to monitor the effectiveness of their treatment plan.
7. A research study includes bone-material quality testing of the tibia to investigate the impact of a new medication on bone health.
8. A patient with a suspected bone disorder undergoes microindentation of the tibia to aid in diagnosis.
9. A postoperative patient undergoes bone-material quality testing of the tibia to assess the success of the surgical procedure.
10. A patient with a family history of osteoporosis undergoes tibial microindentation to evaluate their risk of developing the condition.