Author Topic: Procedure 77080  (Read 1980 times)

MDO VN

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Procedure 77080
« on: October 26, 2008, 11:45:41 AM »
Hi Michele,

I have many claims with CPT 77080 denied these days when it goes with DX 724.5 or 729.5 (invalid), can I use DX 724.2 instead?

Thanks,
Kristy

Michele

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Re: Procedure 77080
« Reply #1 on: October 26, 2008, 04:06:45 PM »
Kristy,

  I'm not sure it's being denied due to the diagnosis.  It may be due to the circumstances.  The following is a general guideline for billing the 77080:

    * CPT 77078, CPT 77080, and CPT 0028T:
          o Every two years for women older than 60 years of age.
          o Every year for women on pharmacological therapy for osteoporosis.
          o Every year for women or men of any age at high risk for osteoporosis or with a diagnosis listed in Payment Guidelines or currently on a prescribed course of steroids.

You need to determine if the 77080 is being denied across the board, or by one insurance carrier in particular.  If it is the same carrier denying, I would call to inquire as to if it's being denied due to the diagnosis, or something else.

Michele



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MDO VN

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Re: Procedure 77080
« Reply #2 on: October 27, 2008, 10:43:33 PM »
Hi Michele,

No, I called carrier and yes, the claims denied due to invalid DX:"No pmt can be made. The DX referenced in claim filed 24E with the CPT. The member is not responsible for this amount", not due to the circumstances. DX 724.5 and 726.5 always denied when go with CPT 77080 :(

I will request doctor office for more appropriate DX to resubmit.

Thanks and have a nice day,
Kristy