How To Use CPT Code 78350

CPT 78350 describes the procedure for a bone density study using single photon absorptiometry. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 78350?

CPT 78350 can be used to describe a bone density study that measures the bone mineral density using single photon absorptiometry. This procedure involves passing a single beam of ionizing radiation through the bone and soft tissue at one or more sites in the appendicular skeleton. The goal is to measure the amount of mineral mass in the bone, which reflects its strength. This code represents both the technical and professional components of the service.

2. Official Description

The official description of CPT code 78350 is: ‘Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry.’

3. Procedure

1. The provider uses a single energy photon beam to measure the bone mineral density.
2. The beam is passed through the bone and soft tissue at one or more sites in the appendicular skeleton.
3. The provider allows the beam to fall on the detector and determines the amount of mineral in the bone.
4. The distal radius is often used as the site of measurement to assess age-related diseases such as osteoporosis.

4. Qualifying circumstances

CPT 78350 is used for patients who require a bone density study to rule out diseases such as osteoporosis. The procedure is typically performed on the appendicular skeleton, with the distal radius being a common site of measurement. The provider must use single photon absorptiometry to measure the bone mineral density.

5. When to use CPT code 78350

CPT code 78350 should be used when a bone density study is performed using single photon absorptiometry. It is appropriate when the provider measures the bone mineral density at one or more sites in the appendicular skeleton. If the provider uses two different energy levels to measure the bone mineral density, CPT code 78351 should be used instead.

6. Documentation requirements

To support a claim for CPT 78350, the provider must document the following information:

• Patient’s diagnosis and the need for a bone density study
• Specific sites measured and the use of single photon absorptiometry
• Date and time of the procedure
• Results of the bone density study
• Signature of the provider

7. Billing guidelines

When billing for CPT 78350, ensure that the procedure is performed using single photon absorptiometry. If reporting only the professional component, append modifier 26 to the radiology code. If reporting only the technical component, append modifier TC to the radiology code. However, payer policy may exempt hospitals from appending modifier TC. Do not append a professional or technical modifier when reporting a global service in which one provider renders both components.

8. Historical information

CPT 78350 was added to the Current Procedural Terminology system on January 1, 1990. The code was later changed on January 1, 2009 to include the term ‘bone mineral content’ in the description.

9. Examples

1. A patient undergoes a bone density study using single photon absorptiometry to assess their risk of osteoporosis.
2. A provider measures the bone mineral density at multiple sites in the appendicular skeleton using single photon absorptiometry for a patient with a history of fractures.
3. A postmenopausal woman undergoes a bone density study at the distal radius to monitor her bone health.
4. A provider performs a bone density study using single photon absorptiometry on a patient with a family history of osteoporosis.
5. A patient with chronic kidney disease undergoes a bone density study to assess their risk of bone loss.
6. A provider measures the bone mineral density at the distal radius using single photon absorptiometry for a patient with rheumatoid arthritis.
7. An elderly patient undergoes a bone density study to evaluate their risk of fractures.
8. A provider performs a bone density study using single photon absorptiometry on a patient who has been on long-term corticosteroid therapy.
9. A postmenopausal woman undergoes a bone density study at multiple sites in the appendicular skeleton to monitor her response to osteoporosis treatment.
10. A provider measures the bone mineral density at the distal radius using single photon absorptiometry for a patient with hyperparathyroidism.