CPT 77080 is a code used for dual-energy X-ray absorptiometry (DXA) bone density studies of the axial skeleton. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 77080 procedures.
1. What is CPT 77080?
CPT 77080 is a medical billing code used for dual-energy X-ray absorptiometry (DXA) procedures, which are noninvasive imaging tests that measure bone mineral density (BMD) in the axial skeleton, such as the hips, pelvis, and spine. These tests help diagnose conditions like osteopenia and osteoporosis, which are characterized by a decrease in bone density and an increased risk of fractures.
2. 77080 CPT code description
The official description of CPT code 77080 is: “Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (e.g., hips, pelvis, spine).”
The 77080 procedure involves the following steps:
- The patient lies on a table, fully clothed.
- The technician positions the DXA scanner over the patient’s hip, pelvis, or lower spine region.
- Two X-ray beams with different energy levels are aimed at the patient’s bones.
- Soft tissue absorption is subtracted out, and the BMD is determined from the absorption of each beam by the bone.
- The absorptiometry is interpreted by a physician, who compares the patient’s BMD to a standard reference population to calculate a T-score.
4. Qualifying circumstances
Patients who are eligible to receive CPT code 77080 services include those with:
- A history of fractures or a family history of osteoporosis
- Postmenopausal women not receiving estrogen therapy
- Individuals with certain medical conditions or taking medications known to affect bone density
- Patients undergoing long-term glucocorticoid therapy
- Individuals being monitored for response to osteoporosis treatment
5. When to use CPT code 77080
It is appropriate to bill the 77080 CPT code when a physician orders a DXA scan to assess a patient’s bone mineral density for the diagnosis or monitoring of osteopenia or osteoporosis, or to evaluate the patient’s risk of fractures. The code can also be used when a patient meets the qualifying circumstances mentioned above.
6. Documentation requirements
To support a claim for CPT 77080, the following information should be documented:
- Patient’s medical history, including risk factors for osteoporosis or fractures
- Physical examination findings
- Indication for the DXA scan, such as diagnosis or monitoring of osteopenia or osteoporosis
- Site(s) of the scan (e.g., hip, pelvis, spine)
- Results of the scan, including BMD measurements and T-scores
- Physician’s interpretation of the results and any recommendations for treatment or follow-up
7. Billing guidelines
When billing for CPT code 77080, keep in mind the following guidelines and rules:
- Do not report CPT 77080 in conjunction with CPT 77085 or CPT 77086.
- Ensure that the patient meets the qualifying circumstances for the procedure.
- Document all necessary information to support the claim, as outlined in the documentation requirements section.
- Follow any payer-specific guidelines or requirements for billing CPT 77080.
8. Historical information
CPT 77080 was added to the Current Procedural Terminology system on January 1, 2007. There have been no updates to the code since its addition.
9. Similar codes to CPT 77080
Five similar codes to CPT 77080 and how they differ are:
- CPT 77081: Measures BMD at peripheral sites, such as the wrist or heel.
- CPT 77082: Measures BMD at multiple sites using a single X-ray absorptiometry device.
- CPT 77083: Measures BMD using quantitative ultrasound (QUS) instead of DXA.
- CPT 77085: Combines axial skeleton DXA with vertebral fracture assessment.
- CPT 77086: Vertebral fracture assessment only, without a BMD measurement.
Here are 10 detailed examples of CPT code 77080 procedures:
- A 65-year-old postmenopausal woman with a family history of osteoporosis undergoes a DXA scan of her lumbar spine and left hip.
- A 70-year-old man with a history of glucocorticoid use has a DXA scan of his lumbar spine and both hips to assess his bone density.
- A 60-year-old woman with a previous wrist fracture has a DXA scan of her pelvis and lumbar spine to evaluate her risk of future fractures.
- A 55-year-old woman undergoing treatment for osteoporosis has a follow-up DXA scan of her lumbar spine to monitor her response to therapy.
- A 75-year-old man with a history of prostate cancer and androgen deprivation therapy undergoes a DXA scan of his lumbar spine and right hip.
- A 68-year-old woman with rheumatoid arthritis and long-term prednisone use has a DXA scan of her lumbar spine and both hips to assess her bone density.
- A 72-year-old woman with a history of multiple fractures undergoes a DXA scan of her lumbar spine, pelvis, and left hip to evaluate her risk of future fractures.
- A 62-year-old man with a history of smoking and alcohol use has a DXA scan of his lumbar spine and right hip to assess his bone density.
- A 58-year-old postmenopausal woman with a family history of osteoporosis undergoes a DXA scan of her lumbar spine and both hips to evaluate her risk of future fractures.
- A 66-year-old woman with a history of thyroid disease and long-term levothyroxine use has a DXA scan of her lumbar spine and left hip to assess her bone density.