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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.

PET

Mammography

Ultrasound

X-ray

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

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Additional Resources

Medical Diagnostics Reimbursement Resources

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

Professional Societies