Summary & Overview

CPT 0815T: REMS Ultrasound Bone Density and Fracture‑Risk Assessment

CPT code 0815T represents an ultrasound–based radiofrequency echographic multi–spectrometry (REMS) procedure for bone-density measurement and fracture-risk assessment. The test is a noninvasive imaging alternative to x‑ray–based densitometry and is relevant nationally as clinicians and payers evaluate options for osteoporosis screening and monitoring. REMS delivers quantitative information about bone structure at sites such as the hip, pelvis, and spine without ionizing radiation, which may influence utilization and coverage decisions.

Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a summary of coverage patterns and payer considerations, typical sites of service and clinical indications, and benchmarks where available. The publication also outlines the clinical context for REMS relative to bone‑density assessment and fracture-risk stratification.

The report covers: payer coverage landscapes, common billing and coding considerations for CPT code 0815T, clinical use cases and limitations, and gaps where Data not available in the input. This national overview is intended to inform payers, providers, and health policy stakeholders about the role of REMS in bone-health evaluation.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 0815TREMSbone density assessmentfracture riskdiagnostic imagingultrasoundosteoporosis screeningnoninvasive testing

Billing Code Overview

CPT code 0815T describes an ultrasound–based radiofrequency echographic multi–spectrometry (REMS) bone–density study and fracture–risk assessment. The procedure uses a noninvasive ultrasound probe placed at one or more skeletal sites (such as the hips, pelvis, or spine) to collect detailed information about bone structure and density. The captured spectral and structural data are analyzed to estimate bone health and fracture risk.

Service Type: Diagnostic imaging / bone density assessment

Typical Site of Service: Outpatient imaging center or clinic (noninvasive ultrasound exam of hips, pelvis, or spine)

Clinical & Coding Specifications

Clinical Context

A typical patient is a postmenopausal woman or an older man with clinical risk factors for osteoporosis or metabolic bone disease who is referred for a non‑ionizing bone‑density study and fracture‑risk assessment. The visit usually begins in an outpatient imaging or specialty clinic (endocrinology, rheumatology, geriatrics, or orthopedic bone health clinic). The patient history includes prior fragility fractures, long‑term corticosteroid use, low body mass index, family history of osteoporosis, or follow‑up after antiresorptive/osteoanabolic therapy. The provider explains the REMS technique and confirms the absence of contraindications (open wounds at probe site or interfering implants at the scanned region). A trained sonographer or clinician places the noninvasive ultrasound probe over one or more sites (hip, pelvis, lumbar spine) and acquires multi‑spectral echographic data. The system software analyzes bone structure and estimates bone density and fracture risk; the interpreting clinician reviews images and generates a report that includes quantitative results and clinical interpretation. Typical documentation includes indication, scanned sites, comparative prior study (if available), technical factors, and final impression for use in treatment planning or monitoring therapy.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or complexity substantially exceeds the usual for the REMS study and documentation supports unusual time, effort, or complexity.

| Professional component | Use when reporting only the interpreting physician's professional component separate from the technical component.

Taxonomy Code	Specialty	Notes
`207RH0000X`	Radiology — Diagnostic Radiology	Radiologists interpret REMS studies and provide imaging reports.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M80.08XA`	Age‑related osteoporosis with current pathological fracture, upper arm, initial encounter	Osteoporosis with fragility fracture is a primary indication for bone‑density and fracture‑risk assessment using REMS.

M81.0 | Age‑related osteoporosis without current pathological fracture | Common screening diagnosis for patients undergoing bone density assessment to diagnose osteoporosis.

M85.8 | Other specified disorders of bone density and structure | Used for less common metabolic bone disorders that may prompt structural bone assessment.

E03.9 | Hypothyroidism, unspecified | Endocrine disorders like hypothyroidism can affect bone health and be relevant in evaluating fracture risk.

M05.79 | Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or systems involvement | Chronic inflammatory conditions treated with long‑term corticosteroids increase osteoporosis risk and justify bone‑density testing.

Z79.899 | Other long term (current) drug therapy | Used when documenting long‑term corticosteroid or other medications that increase fracture risk and indicate need for bone assessment.

Z13.820 | Encounter for screening for osteoporosis | Screening encounter code commonly used when REMS is performed for routine osteoporosis screening.

Z79.51 | Long term current use of bisphosphonates | Used when monitoring therapy effect via bone‑density assessment such as REMS.

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