CPT code 76070 is for a CT scan that measures bone density in an axial view, helping assess bone health and diagnose conditions like osteoporosis.
CPT code 76070 is used to describe a computed tomography (CT) scan that measures bone density in an axial plane. This procedure involves using CT imaging technology to assess the density of bones, which can help in diagnosing conditions like osteoporosis or other bone-related disorders. The axial plane refers to the horizontal slice of the body, allowing for detailed cross-sectional images of the bones to be captured and analyzed.
1. Modifier 26 - Professional Component: Similar to 76066, this modifier is used when billing only for the professional component, which includes the interpretation of the imaging study.
2. Modifier TC - Technical Component: This modifier is used when billing only for the technical component, which includes the use of equipment and technician services.
3. Modifier 59 - Distinct Procedural Service: This modifier is applicable when the CT bone density axial scan is performed as a distinct service from other procedures on the same day.
4. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used if the CT bone density axial scan is repeated by the same physician on the same day, indicating necessity.
5. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used if the CT bone density axial scan is repeated by a different physician on the same day, indicating necessity.
These modifiers help ensure accurate billing and reimbursement by providing additional context about the services rendered. Proper use of modifiers is crucial for compliance and to avoid claim denials.
The CPT code 76070 is subject to reimbursement considerations under Medicare, specifically through the Medicare Physician Fee Schedule (MPFS). Whether this code is reimbursed by Medicare can depend on several factors, including the specific guidelines and policies set forth by the Medicare Administrative Contractor (MAC) in your region.
Each MAC has the authority to determine coverage and reimbursement based on local coverage determinations (LCDs) and national coverage determinations (NCDs). Therefore, it is essential for healthcare providers to consult the MPFS and their respective MAC to verify if CPT code 76070 is reimbursed and to understand any specific documentation or medical necessity requirements that may apply.
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