ICD-10 Codes for Bone Density Screening
For routine osteoporosis screening in asymptomatic patients, use Z13.820 (Encounter for screening for osteoporosis).
Primary Screening Code
- Z13.820 is the appropriate ICD-10 code for encounter for screening for osteoporosis in asymptomatic individuals who meet age and risk factor criteria for bone density testing 1.
Age-Based Screening Indications
The following patients qualify for screening bone density testing and can be coded with Z13.820:
- Women aged ≥65 years (routine asymptomatic screening) 1
- Men aged ≥70 years (routine asymptomatic screening) 1
Risk Factor-Based Screening Codes
For younger patients with risk factors, you may need to use additional codes alongside Z13.820 to justify medical necessity:
Women <65 years or Men <70 years with Risk Factors:
- Z87.310 - Personal history of (healed) osteoporosis fracture (for prior fragility fracture) 1
- Z79.4 - Long-term (current) use of insulin (for diabetes-related bone loss) 1
- Z79.51 - Long-term (current) use of inhaled steroids 1
- Z79.52 - Long-term (current) use of systemic steroids (≥3 months of prednisone ≥5 mg/day equivalent) 1
- E28.310 - Symptomatic premature menopause (estrogen deficiency) 1
- Z87.820 - Personal history of maternal hip fracture after age 50 1
- F17.210 - Nicotine dependence, cigarettes (current smoking) 1
Diagnostic Codes for Established Disease
If the patient has already been diagnosed with osteoporosis or osteopenia, do not use screening codes. Instead use:
- M81.0 - Age-related osteoporosis without current pathological fracture 2, 3
- M85.80 - Other specified disorders of bone density and structure, unspecified site (for osteopenia/low bone mass) 3
Special Clinical Scenarios Requiring Screening
Additional ICD-10 codes that justify bone density screening include:
- E21.0 - Primary hyperparathyroidism 1
- E05.90 - Thyrotoxicosis, unspecified (hyperthyroidism) 1
- E24.9 - Cushing syndrome, unspecified 1
- C61 - Malignant neoplasm of prostate (for men on androgen deprivation therapy) 1
- Z90.710-Z90.721 - Acquired absence of ovary/testes (surgical or chemical castration) 1
- E66.01 - Morbid obesity due to excess calories (for post-bariatric surgery patients) 1
Common Pitfalls to Avoid
- Do not use Z13.820 for follow-up DXA scans in patients with established osteoporosis—use the specific osteoporosis diagnosis code (M81.0) instead 2, 3
- Do not use screening codes for symptomatic patients with acute back pain or suspected vertebral fracture—use symptom-based codes (M54.5 for low back pain, M80.08XA for pathological vertebral fracture) 2
- Always document risk factors in the medical record when screening patients younger than standard age thresholds, as payers may deny claims without proper justification 1
- For monitoring therapy effectiveness, use the established disease code (M81.0) rather than screening code, as this is surveillance not screening 1