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Excellus BlueCross BlueShieldCommercial · Coverage · Radiology (x-rays) & Imaging · NY · Radiology, Endocrinology, Internal Medicine +1 moreHigh impact

Bone Densitometry/Bone Density Studies 6.01.05

Effective date
Aug 20, 2026
Identified
Jun 20, 2026

Summary

Effective August 20, 2026, VFA with DEXA and TBS was removed from the list of investigational screening procedures, and DEXA can be completed with or without VFA or TBS. BMD testing is considered medically necessary when one of the listed methods is used, including DEXA, and one of the listed indications is met. Follow-up BMD testing is considered medically appropriate every two years, when at least 23 months have passed since the month of the last test, and testing every three years is recommended after starting bisphosphonate therapy.

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What to do

Action · 6 steps
01Already effective August 20, 2026: Before billing, confirm in the subscriber contract whether the member's coverage is subject to the New York State BMD testing mandate.
02A DEXA study of multiple sites should be reported and will be processed as a single unit of service.
03Testing is not indicated unless the results influence a treatment decision.
04Follow-up BMD testing is considered medically appropriate every two years, when at least 23 months have passed since the month the last BMD test was performed.
05Pulse-echo ultrasound of the tibia, REMS, and VFA with SEXA or automated CT analysis are listed as investigational screening procedures.
06When CPT 76999 is used to report pulse-echo ultrasound for bone density testing, consider it experimental or investigational.

Codes mentioned

7697776999770787708077081770857708677089770907709177092G0130E29.1E34.2E89.40E89.41E89.5E28.39N92.4R29.890Z08Z09Z13.820Z78.0

Original notice

Bone Densitometry/Bone Density Studies 6.01.05
excellusbcbs.com · Always check the source before changing claims.
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Related policy hubs

Excellus BlueCross BlueShield policiesNY policy changesRadiologyEndocrinologyInternal MedicineOB-GYNCode 76977Code 76999Code 77078Code 77080Code 77081Code 77085Code 77086Code 77089Code 77090Code 77091Code 77092Code G0130Code E29.1Code E34.2Code E89.40Code E89.41Code E89.5Code E28.39Code N92.4Code R29.890Code Z08Code Z09Code Z13.820Code Z78.0

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