CommercialCoverageMedium impact
Osteoporosis screening and fall prevention
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Geriatrics +2 more·Physician
Effective date
Oct 1, 2022
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island updated their osteoporosis screening and fall prevention quality measure for women ages 67-85 who suffered fractures. The policy specifies CPT codes for bone density tests and HCPCS codes for osteoporosis medications that must be provided within 6 months after fracture to meet quality metrics.
Action Required
Quality team should review coding practices for women 67-85 with fractures to ensure proper documentation and billing of bone density tests (CPT 76977, 77078, 77080, 77081, 77085, 77086) and osteoporosis medications (HCPCS J0897, J1740, J3489, J3110, J3111) within 6 months post-fracture. Update encounter forms to prompt providers for osteoporosis management follow-up. Contact QualityHEDIS@bcbsri.org with questions about the quality measure.