Be on the lookout for wrongly denied bone mass tests

Why This Topic Matters

It helps practices determine whether bone mass test denials may stem from processing errors versus coverage or documentation issues, and it highlights the Medicare policy references that govern these services.

Article Sections

1. Medicare denial issue and policy update

   Introduces the reported denial problem and the Medicare policy update that prompted the clarification. It explains the general claims-processing context and why affected practices should review rejected claims.

2. Correct coding for bone mass measurement testing

   Discusses the testing technologies used for bone mass measurement and the need to align claims with the relevant diagnosis categories. It distinguishes the handling of axial testing from other technologies under Medicare guidance.

3. Claims processing clarification for non-axial procedures

   Summarizes the Medicare clarification addressing certain procedure codes that were being denied when paired with screening and osteoporosis-related diagnoses. It references the updated claims-processing language and local diagnosis code lists.

4. Check BMM coverage limits, too

   Reviews Medicare coverage and frequency standards for bone mass measurement and notes patient risk factors discussed in the article. It also identifies additional testing types that Medicare does not cover and directs readers to manual references.