Mount Carmel Health Partners HEDIS Tip Sheets

HEDIS Tip Sheet Osteoporosis Management in Women Who Have Had a Fracture Definition: Percentage of women 67 – 85 years of age who suffered a fracture and who had either a bone mineral density (BMD) test [DEXA scan] or prescription for a drug to treat or prevent osteoporosis within the six months after the fracture. The fracture must have occurred between July 1 prior to the measurement year and June 30 of the measurement year. Service Needed: Testing or treatment for osteoporosis after the fracture: • A BMD test [DEXA scan] on the date of fracture or within the 180-day (6-month) period after. • A BMD test [DEXA scan] during the inpatient stay for the fracture (applies only to fractures requiring hospitalization). • A dispensed prescription to treat osteoporosis on the date of fracture or within the 180-day (6-month) period after. Coding: CPT 4 HCPCS ICD-10-PCS Bone Mineral Density Test: 76977, 77078, 77080 – 77082, 77085 - 77086 Bone Mineral Test: Injection, calcitonin salmon, up to 400 units Injection, Denosumab, 1 mg Injection, Ibandronate sodium, 1 mg Injection, Teriparatide, 10 mg Injection, Zoledronic acid (zometa), 1 mg Injection, Zoledronic acid (reclas), 1 mg Injection, Zoledronic acid ,1 mg Injection, Zoledronic acid, not otherwise classified, 1 mg Ultrasonography of Right Shoulder, Densitometry G0130 J0630 J0897 J1740 J3110 J3487 J3488 J3489 Q2051 Ultrasonography of Left Shoulder, Densitometry Ultrasonography of Right Elbow, Densitometry Ultrasonography of Left Elbow, Densitometry Ultrasonography of Right Wrist, Densitometry Ultrasonography of Left Wrist, Densitometry Ultrasonography of Right Hand, Densitometry Ultrasonography of Left Hand, Densitometry Plain Radiography of Right Hip, Densitometry Plain Radiography of Left Hip, Densitometry Plain Radiography of Right Femur, Densitometry Plain Radiography of Left Femur, Densitometry Plain Radiography of Cervical Spine, Densitometry Plain Radiography of Thoracic Spine, Densitometry Plain Radiography of Lumbar Spine, Densitometry Plain Radiography of Whole Spine, Densitometry BP49ZZ1 BP4GZZ1 BP4HZZ1 BP4LZZ1 BP4MZZ1 BP4NZZ1 BP4PZZ1 BQ00ZZ1 BQ01ZZ1 BQ03ZZ1 BQ04ZZ1 BR00ZZ1 BR07ZZ1 BR09ZZ1 BR0GZZ1 30 BP48ZZ1

Mount Carmel Health Partners HEDIS Tip Sheets | Page 30