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CodeMap** Reimbursement Calculator

This information is provided as a convenience for GE Healthcare customers by CodeMap. CodeMap is responsible for the accuracy of all content. While every reasonable effort is made to ensure that all payment amounts and regulatory information is current and complete, it is the responsibility of each user to verify specific coverage and payment information with their Medicare contractors. All questions regarding the accuracy or sources of information on this website should be directed to CodeMap at customer_service@codemap.com.

Reimbursement Information

Reimbursement information on coding, coverage and payment amounts for specific imaging services like bone densitometry, computed tomography, nuclear medicine, and ultrasound procedures.

General

Bone Densitometry

Computed Tomography (CT)

Electrophysiology and Arrhythmia Service Procedures

ENT

  •   Reimbursement for Image-guided Endoscopic Sinus Surgical Procedures

    • Mammography

    Molecular Breast Imaging

    Needle Guidance/Placement

    Nuclear Medicine

    PET

    Ultrasound

    Vscan

    CMS Comment Letters

    Coverage Policies

    Some representative private and public payer clinical policies that are transparent to the public are accessible via these web links. Remember to contact the payer since specific coverage decisions are based on a member benefit plan.


    Carrier Web Link
    Local Coverage Determinations
    Carrier Name State Web Link Comment
    Aetna National Medical - Physicians, hospitals, facilities and administrators Click on Clinical Policy Bullentins (left side), accept terms, type in 77080 in search feature
    BCBS Alabama Blue Cross and Blue Shield of Alabama : Providers : Use of "Physicians' Current Procedural Terminology," (CPT) Accept terms, select "B", page down to Bone Mineral Density
    BCBS - Premera Alaska Premera Blue Cross - Reference Info,Medical Policies Accept terms, no written coverage policy - check under Bone Mass Measurement
    BCBS Arizona AzBlue.com for Providers Password Protected, may or may not have a written coverage policy
    BCBS Arkansas Coverage Policy - Providers - Arkansas Blue Cross and Blue Shield Accept terms, type in search feature 77080
    BC - Wellpoint (AKA Anthem) California BlueCross of California Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BS - CA California Guidelines & Resources - Provider Connection - Blue Shield of California Password Protected, may or may not have a written coverage policy
    BCBS - Anthem Colorado Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS - Anthem Connecticut Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS - Carefirst Delaware Blue Cross Blue Shield of Delaware: Providers Password Protected, Contact carrier for billing guidelines, service request form available
    BCBS - Carefirst DC Provider Services - CareFirst BlueCross BlueShield Accept terms, click on table of contents, click on Radiology, No written policy
    BCBS Florida BCBSF Medical Coverage Guidelines (MCG) Click on Radiology, click on Bone Mineral Density Studies
    BCBS Georgia BlueCross BlueShield of Georgia Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS - HMSA Hawaii Medical Policies Click on Bone (Mineral) Density Studies
    BC - Premera Idaho Blue Cross of Idaho - Home Page Click on Continue, click on Radiology, Click on Bone Mineral Density
    BS Regence Idaho The Regence Group Medical Policy Manual Accept terms, click on table of contents, click on Radiology, click on Bone Mineral Density
    BCBS Illinois BCBSIL/Provider Medical Policies on Fyiblue Click on I Agree, Search by 77080 - currently no written coverage policy
    BCBS - Wellpoint (AKA Anthem) Indiana Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS - WellMark Iowa Wellmark Providers Click on Medical Policies, accept terms, enter CPT 77080
    BCBS Kansas BCBSKS - Medical Review - Institutional - Medical Policies Within search feature type in 77080, click on Medical Policy
    BCBS - Anthem Kentucky Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS Louisana BCBSLA - Medical Policy Coverage Guidelines Password Protected, may or may not have a written coverage policy
    BCBS - Anthem Maine Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS - Carefirst Maryland Provider Services - CareFirst BlueCross BlueShield Accept terms, click on table of contents, click on Radiology, No written policy
    BCBS Massachuettes Medical Policies Click on B, page down to Bone Densitometry
    BCBS Michigan Blue Cross Blue Shield of Michigan - Welcome Providers Password Protected, may or may not have a written coverage policy
    BCBS Minnesota Blue Cross and Blue Shield of Minnesota Accept terms, click view all active policies, no written policy on file
    BCBS Mississippi Blue Cross & Blue Shield of Mississippi | Medical Policy Search Click on view
    BC - Anthem Missouri Anthem Medical Policies ^ Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS Missouri Blue Cross Blue Shield of Kansas City : BCBSKC Home Password Protected, may or may not have a written coverage policy
    BCBS Missouri BCBSMT Medical Policies Accept terms, click on "B", page down to Bone Mineral Density
    BCBS Nebraska BCBSNE - Medical Policy Disclaimer Accept terms, no written coverage policy - check under Bone Mass Measurement
    BCBS - Anthem Nevada Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS - Anthem New Hampshire Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS - Horizon New Jersey https://services5.horizon-bcbsnj.com/eprise/main/horizon/tsnj/tsweb/Medical_Policies_Guidelines.html Click on Medical Policies, accept terms, click on Alphabetical, click on B, page down to Bone Density Studies
    BCBS New Mexico Welcome, Providers Click on I Agree, Search by 77080 - currently no written coverage policy
    BCBS-Western NY New York BlueCross BlueShield of Western New York Clinical Protocols Select B - no written policy on file
    BS of Northeastern New York BlueShield of Northeastern New York Clinical Protocols Select B - no written policy on file
    BCBS-Empire New York Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS-Excellus New York Excellus BlueCross BlueShield Accept terms, type in search Bone Densitometry
    BCBS North Carolina Medical policy search Type in 77080 in search feature, click on PDF Bone Mineral Density
    BCBS North Dakota BCBSND: Providers - Medical Policy Accept terms, click on enter medical policy, click on "B", page down to Bone Density studies
    BCBS - Anthem Ohio Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS Oklahoma Health Insurance Offered by Anthem Blue Cross and Blue Shield Click on I Agree, Search by 77080 - currently no written coverage policy
    BCBS - Regence Oregon The Regence Group Medical Policy Manual Accept terms, click on table of contents, click on Radiology, click on Bone Mineral Density
    BC - Noetheastern Pennsylvania BCNEPA - Our Health Plans - Experimental/Investigative Medical Policies No written policy
    BCBS-Highmark Pennsylvania Highmark Medical Policy Search Click on search by CPT 77080, click on Bone Mineral Density studies
    BCBS-Capital Pennsylvania Providers - Main - www.capbluecross.com Password Protected, may or may not have a written coverage policy
    BCBS-Independence Pennsylvania Medical Policy Accept terms, no written coverage policy - check under Bone Mass Measurement
    BCBS Rhode Island Blue Cross & Blue Shield of Rhode Island - Sign In Password Protect, may or may not have a written policy
    BCBS South Carolina Welcome to SouthCarolinaBlues.com for Providers Click on Medical Policies, right hand side, accept terms, click on "B" no written policy currently
    BCBS - WellMark South Dakota Wellmark Providers Click on Medical Policies, accept terms, enter CPT 77080
    BCBS Tennessee Providers - BCBST.com Type in Bone Mass Measurement in search feature
    BCBS Texas BCBSTX Providers Medical Policies on Fyiblue Type in CPT code 77080, click on CPT search - no written policy
    BCBS - Regence Utah The Regence Group Medical Policy Manual Accept terms, click on table of contents, click on Radiology, click on Bone Mineral Density
    BCBS Vermont Blue Cross Blue Shield Vermont: Home Page Click on provider, password protected, may or may not have a written policy
    BCBS - Anthem Virginia Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BC- Premera Washington Premera Blue Cross - Reference Info,Medical Policies Accept terms, no written coverage policy - check under Bone Mass Measurement
    BS - Regence Washington The Regence Group Medical Policy Manual Accept terms, click on table of contents, click on Radiology, click on Bone Mineral Density
    BCBS West Virginia Mountain State BCBS - Medical Policy No written policy
    BCBS - Anthem Wisconsin Anthem Medical Policies and Clinical UM Guidelines Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18
    BCBS Wyoming BCBSWY: Providers Password Protected, may or may not have a written coverage policy
    Cigna National CIGNA Healthcare for Health Care Professionals - Coverage Positions Click on "B", page down to Bone Mineral Density
    Healthnet Various States Health Net Provider Page down to Bone Mineral Density
    Humana National Clinical & Healthcare Resources No written policy
    CMS (Centers for Medicare and Medicaid Services) National Centers for Medicare & Medicaid Services click on search, select local, select state, select CPT 77080
    United Healthcare National UnitedHealthcare Online Click on Medical Policies, accept terms, page down to Bone Densitometry

    What's New in Policy Updates

    Computed Tomography

    Hospital Outpatient Reimbursements for Pelvic/Abdominal CT - January 2012


    Additional Resources

    Medical Diagnostics Reimbursement Resources

    Medical Diagnostics Reimbursement Resources offer the latest information on coding, coverage and payment for contrast media and radiopharmaceuticals.

    Groups & Initiatives

    GE Healthcare advocates for the timely patient access to medically appropriate, high quality imaging services, provided by knowledgeable and skilled providers of care. GE advocates this position by working with and supporting the following groups and initiatives:

    Professional Societies