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Official Description

Bone age studies

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Bone age studies are a diagnostic procedure utilized to evaluate the skeletal development of children through the analysis of radiographic films. This method involves taking X-rays of the child's hand and wrist, which are then compared to established 'normal' reference X-rays that correspond to various ages. The primary objective of these studies is to estimate the child's bone age, which can provide valuable insights into their growth patterns and developmental status. There are two main approaches to conducting bone age studies. The first method entails a systematic assessment of the maturity of all the bones present in the hand and wrist, allowing for a comprehensive evaluation of skeletal development. The second method is a modified and expedited version, where the overall appearance of a single radiograph is compared to the reference radiographs, and the closest match is selected to determine the child's bone age. It is crucial to address any growth retardation before the bones undergo fusion, as this process signifies the cessation of further bone growth, making timely intervention essential for optimal developmental outcomes.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Bone age studies are indicated for various clinical scenarios where assessing skeletal maturity is essential. The following conditions may warrant the performance of this procedure:

  • Growth Retardation - When a child exhibits signs of delayed growth or development, bone age studies can help determine if the growth is within normal limits or if there are underlying issues that need to be addressed.
  • Precocious Puberty - In cases where a child shows early signs of puberty, bone age studies can assist in evaluating whether the skeletal development aligns with the chronological age or if it is advanced.
  • Endocrine Disorders - Conditions affecting hormonal balance, such as hypothyroidism or growth hormone deficiencies, may require bone age assessment to guide treatment decisions.
  • Assessment of Growth Disorders - Children with known growth disorders may undergo bone age studies to monitor their skeletal development over time and assess the effectiveness of therapeutic interventions.

2. Procedure

The procedure for conducting bone age studies involves several key steps that ensure accurate assessment of skeletal maturity. The following outlines the procedural steps:

  • Step 1: Patient Preparation - The child is positioned comfortably, and the area of interest, typically the hand and wrist, is exposed for imaging. It is important to ensure that the child remains still during the X-ray process to obtain clear images.
  • Step 2: Radiographic Imaging - X-rays of the child's hand and wrist are taken. These images capture the bones in detail, allowing for a thorough evaluation of their development. The radiographs should be of high quality to facilitate accurate comparison with reference images.
  • Step 3: Comparison with Reference Standards - The obtained X-rays are then compared to established reference X-rays that represent normal skeletal development at various ages. This comparison can be done systematically by assessing the maturity of all bones in the hand and wrist or through a modified method that evaluates the overall appearance of the radiograph.
  • Step 4: Determination of Bone Age - Based on the comparison, the clinician determines the child's bone age. This information is crucial for understanding the child's growth trajectory and making informed decisions regarding any necessary interventions.

3. Post-Procedure

After the bone age study is completed, the child may resume normal activities immediately, as there are typically no restrictions following the procedure. The results of the bone age assessment will be documented and communicated to the referring physician, who will interpret the findings in the context of the child's overall health and growth patterns. If any abnormalities or concerns are identified, further evaluation or treatment may be recommended to address potential growth issues. Regular follow-up assessments may also be necessary to monitor the child's development over time.

Short Descr BONE AGE STUDIES
Medium Descr BONE AGE STUDIES
Long Descr Bone age studies
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator STV-Packaged Codes
ASC Payment Indicator Packaged service/item; no separate payment made.
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I1B - Standard imaging - musculoskeletal
MUE 1
CCS Clinical Classification 226 - Other diagnostic radiology and related techniques
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CR Catastrophe/disaster related
FY X-ray taken using computed radiography technology/cassette-based imaging
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
Date
Action
Notes
2025-01-01 Changed Short Description changed.
2007-01-01 Added First appearance in code book in 2007.
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