Payment Guidelines for BMM:
Applicable CPT Codes
| Code | Description |
| 76977 | Ultrasound bone density measurement and interpretation, peripheral site(s), any method |
| 77078 | Computed tomography, bone mineral density study, 1 or more sites; axial skeleton (e.g., hips, pelvis, spine) |
| 77079 | Computed tomography, bone mineral density study, 1 or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) |
| 77080 | Dual energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (e.g., hips, pelvis, spine) |
| 77081 | Dual energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) |
| 77083 | Radiographic absorptiometry (e.g., photodensitometry, radiogrammetry), 1 or more sites |
| G0130 | Single energy x-ray absorptiometry (SEXA) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) |
Applicable ICD-9 Diagnosis Codes
| Code | Description |
| 241.0 | Nontoxic uninodular goiter |
| 246.9 | Unspecified disorder of thyroid |
| 252.00 | Hyperparathyroidism, unspecified |
| 252.01 | Primary hyperparathyroidism |
| 252.02 | Secondary hyperparathyroidism, non-renal |
| 252.08 | Other hyperparathyroidism |
| 255.0 | Cushing’s syndrome |
| 256.2 | Postablative ovarian failure |
| 256.31 | Premature menopause |
| 256.39 | Other ovarian failure |
| 259.3 | Ectopic hormone secretion, not elsewhere classified |
| 627.0 | Premenopausal menorrhagia |
| 627.1 | Postmenopausal bleeding |
| 627.2 | Symptomatic menopausal or female climacteric states |
| 627.3 | Postmenopausal atrophic vaginitis |
| 627.4 | Symptomatic states associated with artificial menopause |
| 627.8 | Other specified menopausal and postmenopausal disorder |
| 627.9 | Unspecified menopausal and postmenopausal disorder |
| 733.00 | Unspecified osteoporosis |
| 733.01 | Senile osteoporosis |
| 733.02 | Idiopathic osteoporosis |
| 733.03 | Disuse osteoporosis |
| 733.09 | Other osteoporosis |
| 733.12 | Pathologic fracture of distal radius and ulna |
| 733.13 | Pathologic fracture of vertebrae |
| 733.14 | Pathologic fracture of neck of femur |
| 733.15 | Pathologic fracture of other specified part of femur |
| 733.16 | Pathologic fracture of tibia and fibula |
| 733.19 | Pathologic fracture of other specified site |
| 733.90 | Disorder of bone and cartilage, unspecified |
| 733.93 | Stress fracture of tibia or fibula |
| 733.94 | Stress fracture of the metatarsals |
| 733.95 | Stress fracture of other bone |
| 756.51 | Osteogenesis imperfecta |
| 758.6 | Gonadal dysgenesis |
| 781.91 | Loss of height |
| 793.7 | Nonspecific abnormal findings on radiological and other examination of musculoskeletal system |
| 805.00 | Closed fracture of cervical vertebra, unspecified level without mention of spinal cord injury |
| 805.01 | Closed fracture of first cervical vertebra without mention of spinal cord injury |
| 805.02 | Closed fracture of second cervical vertebra without mention of spinal cord injury |
| 805.03 | Closed fracture of third cervical vertebra without mention of spinal cord injury |
| 805.04 | Closed fracture of fourth cervical vertebra without mention of spinal cord injury |
| 805.05 | Closed fracture of fifth cervical vertebra without mention of spinal cord injury |
| 805.06 | Closed fracture of sixth cervical vertebra without mention of spinal cord injury |
| 805.07 | Closed fracture of seventh cervical vertebra without mention of spinal cord injury |
| 805.08 | Closed fracture of multiple cervical vertebrae without mention of spinal cord injury |
| 805.1 | Open fracture of cervical vertebra without mention of spinal cord injury |
| 805.10 | Open fracture of cervical vertebra, unspecified level without mention of spinal cord injury |
| 805.11 | Open fracture of first cervical vertebra without mention of spinal cord injury |
| 805.12 | Open fracture of second cervical vertebra without mention of spinal cord injury |
| 805.13 | Open fracture of third cervical vertebra without mention of spinal cord injury |
| 805.14 | Open fracture of fourth cervical vertebra without mention of spinal cord injury |
| 805.15 | Open fracture of fifth cervical vertebra without mention of spinal cord injury |
| 805.16 | Open fracture of sixth cervical vertebra without mention of spinal cord injury |
| 805.17 | Open fracture of seventh cervical vertebra without mention of spinal cord injury |
| 805.18 | Open fracture of multiple cervical vertebrae without mention of spinal cord injury |
| 805.2 | Closed fracture of dorsal (thoracic) vertebra without mention of spinal cord injury |
| 805.3 | Open fracture of dorsal (thoracic) vertebra without mention of spinal cord injury |
| 805.4 | Closed fracture of lumbar vertebra without mention of spinal cord injury |
| 805.5 | Open fracture of lumbar vertebra without mention of spinal cord injury |
| 805.6 | Closed fracture of sacrum and coccyx without mention of spinal cord injury |
| 805.7 | Open fracture of sacrum and coccyx without mention of spinal cord injury |
| 805.8 | Closed fracture of unspecified part of vertebral column without mention of spinal cord injury |
| 805.9 | Open fracture of unspecified part of vertebral column without mention of spinal cord injury |
| 806.00 | Closed fracture of C1-C4 level with unspecified spinal cord injury |
| 806.01 | Closed fracture of C1-C4 level with complete lesion of cord |
| 806.02 | Closed fracture of C1-C4 level with anterior cord syndrome |
| 806.03 | Closed fracture of C1-C4 level with central cord syndrome |
| 806.04 | Closed fracture of C1-C4 level with other specified spinal cord injury |
| 806.05 | Closed fracture of C5-C7 level with unspecified spinal cord injury |
| 806.06 | Closed fracture of C5-C7 level with complete lesion of cord |
| 806.07 | Closed fracture of C5-C7 level with anterior cord syndrome |
| 806.08 | Closed fracture of C5-C7 level with central cord syndrome |
| 806.09 | Closed fracture of C5-C7 level with other specified spinal cord injury |
| 806.10 | Open fracture of C1-C4 level with unspecified spinal cord injury |
| 806.11 | Open fracture of C1-C4 level with complete lesion of cord |
| 806.12 | Open fracture of C1-C4 level with anterior cord syndrome |
| 806.13 | Open fracture of C1-C4 level with central cord syndrome |
| 806.14 | Open fracture of C1-C4 level with other specified spinal cord injury |
| 806.15 | Open fracture of C5-C7 level with unspecified spinal cord injury |
| 806.16 | Open fracture of C5-C7 level with complete lesion of cord |
| 806.17 | Open fracture of C5-C7 level with anterior cord syndrome |
| 806.18 | Open fracture of C5-C7 level with central cord syndrome |
| 806.19 | Open fracture of C5-C7 level with other specified spinal cord injury |
| 806.20 | Closed fracture of T1-T6 level with unspecified spinal cord injury |
| 806.21 | Closed fracture of T1-T6 level with complete lesion of cord |
| 806.22 | Closed fracture of T1-T6 level with anterior cord syndrome |
| 806.23 | Closed fracture of T1-T6 level with central cord syndrome |
| 806.24 | Closed fracture of T1-T6 level with other specified spinal cord injury |
| 806.25 | Closed fracture of T7-T12 level with unspecified spinal cord injury |
| 806.26 | Closed fracture of T7-T12 level with complete lesion of cord |
| 806.27 | Closed fracture of T7-T12 level with anterior cord syndrome |
| 806.28 | Closed fracture of T7-T12 level with central cord syndrome |
| 806.29 | Closed fracture of T7-T12 level with other specified spinal cord injury |
| 806.30 | Open fracture of T1-T6 level with unspecified spinal cord injury |
| 806.31 | Open fracture of T1-T6 level with complete lesion of cord |
| 806.32 | Open fracture of T1-T6 level with anterior cord syndrome |
| 806.33 | Open fracture of T1-T6 level with central cord syndrome |
| 806.34 | Open fracture of T1-T6 level with other specified spinal cord injury |
| 806.35 | Open fracture of T7-T12 level with unspecified spinal cord injury |
| 806.36 | Open fracture of T7-T12 level with complete lesion of cord |
| 806.37 | Open fracture of T7-T12 level with anterior cord syndrome |
| 806.38 | Open fracture of T7-T12 level with central cord syndrome |
| 806.39 | Open fracture of T7-T12 level with other specified spinal cord injury |
| 806.4 | Closed fracture of lumbar spine with spinal cord injury |
| 806.5 | Open fracture of lumbar spine with spinal cord injury |
| 806.60 | Closed fracture of sacrum and coccyx with unspecified spinal cord injury |
| 806.61 | Closed fracture of sacrum and coccyx with complete cauda equina lesion |
| 806.62 | Closed fracture of sacrum and coccyx with other cauda equina injury |
| 806.69 | Closed fracture of sacrum and coccyx with other spinal cord injury |
| 806.70 | Open fracture of sacrum and coccyx with unspecified spinal cord injury |
| 806.71 | Open fracture of sacrum and coccyx with complete cauda equina lesion |
| 806.72 | Open fracture of sacrum and coccyx with other cauda equina injury |
| 806.79 | Open fracture of sacrum and coccyx with other spinal cord injury |
| 806.8 | Closed fracture of unspecified vertebra with spinal cord injury |
| 806.9 | Open fracture of unspecified vertebra with spinal cord injury |
| E932.0 | Adrenal cortical steroids causing adverse effect in therapeutic use |
| V45.77 | Acquired absence of organ, genital organs |
| V49.81 | Asymptomatic postmenopausal status (age-related) (natural) |
| V58.65 | Long-term (current) use of steroids |
| V58.69 | Encounter for long-term (current) use of other medications |
| V67.51 | Follow-up examination following completed treatment with high-risk medications, not elsewhere classified |
Non-Reimbursable CPT Codes
| Code | Description |
| 78350 | Bone density (bone mineral content) study, 1 or more sites, single photon absorptiometry |
| 78351 | Bone density (bone mineral content) study, 1 or more sites; dual photon absorptiometry, 1 or more sites |