Basics of Trabecular bone score (TBS) CPT codes
Trabecular bone score (TBS) have four new codes for reporting in radiology facility from 2022. Understand that TBS provides measurements for the structural condition of the bone micro-architecture. This intern allows for better predictions of potential risks for major osteoporotic fracture independent of bone mineral density (BMD) and associated clinical risk factors. CPT code 77089, 77090, 77091 & 77092 are added for coding TBS in radiology facility for coders.
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Description of CPT code 77089, 77090, 77091 & 77092
77089 Trabecular bone score (TBS), structural condition of the bone microarchitecture; using dual X-ray absorptiometry (DXA) or other imaging data on gray-scale variogram, calculation, with interpretation and report on fracture-risk
(Do not report 77089 in conjunction with 77090, 77091, 77092)
77090 technical preparation and transmission of data for analysis to be performed elsewhere
77091 technical calculation only
77092 interpretation and report on fracture-risk only by other qualified health care professional
(Do not report 77090, 77091, 77092 in conjunction with 77089)
The trabecular bone score (TBS) is a diagnostic software tool that analyzes the internal structure of the lumbar spine bones. It is used in conjunction with dual-energy x-ray absorptiometry (DXA), which is an enhanced form of x-ray technology that is performed to measure bone mineral density (BMD). TBS uses standard DXA lumbar spine images to measure the structure of trabecular (cancellous) bone, providing additional information to be used in conjunction with BMD results in calculating fracture risk. Using a software program installed on a standard DXA computer, TBS provides an index of bone structure and quality without requiring additional radiation exposure or scan time. CPT code 77089 is reported for TBS using DXA or other imaging data on grayscale variogram, calculation, and interpretation/report on fracture risk. CPT code 77090 is reported for the technical preparation and transmission of data for an analysis to be performed elsewhere. CPT code 77091 is reported for the technical calculation only. CPT code 77092 is reported for the interpretation and report on fracture risk only by a qualified health care professional.
Clinical Example (CPT code 77090)
A 54-year-old, who is postmenopausal female, presents with current tobacco use, a family history of osteoporosis, and a suspicion of Type II diabetes.
Clinical Example (CPT code 77091)
A 75-year-old male, who has a history of corticosteroids use, presents with bilateral knee osteoarthritis.
Clinical Example ( CPT code 77092)
A 60-year-old female presents with a history of breast cancer treated with anti-aromatase inhibitors.