Coding for dual-energy X-ray absorptiometry (DEXA) scans on the lumbar spine and left forearm

Q.

We performed dual-energy X-ray absorptiometry (DEXA) scans on both the lumbar spine and the left forearm. May we report both CPT^® codes 77080 and 77081?

A.

Yes, you may report both. For Medicare patients, add Level ll HCPCS modifier –XU to CPT 77080 when both are medically necessary and performed. Despite years of saying that CPT 77080 included multiple sites of both the axial and appendicular skeleton and that CPT 77081 should not be reported with CPT 77080, the American Medical Association (AMA) and American College of Radiology (ACR) published an article in Clinical Examples in Radiology (Spring 2019) indicating that both CPT codes could be reported. The Centers for Medicare and Medicaid Services (CMS) updated the bone density national coverage determination (NCD) earlier this year to indicate modifier XU could be used to over-ride the edit when both axial and appendicular exams were performed.