Summary & Overview
CPT 78351: Bone Mineral Density Measurement by Dual-Energy Photon Beams
CPT code 78351 represents a dual-energy photon absorptiometry test to measure bone mineral density (BMD), a key diagnostic tool for detecting low bone mass and assessing osteoporosis-related fracture risk. This imaging procedure is widely used in clinical practice for preventive care and disease monitoring among older adults and patients with conditions that affect bone health. Nationally, accurate coding and coverage for BMD testing influence early diagnosis, clinical management decisions, and population health efforts to reduce fracture incidence.
Key payers addressed in this overview include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and typical settings for the service, along with national coverage context and commonly used modifiers and billing considerations (where provided). The publication highlights what providers and billing teams should expect about site-of-service patterns, clinical indications, and the role of CPT code 78351 in preventive and diagnostic care pathways.
This summary prepares payers, billing professionals, and clinical leaders to understand where 78351 fits in imaging service lines, what it measures clinically, and the types of documentation and coding attention that support appropriate use and reimbursement. Data not available in the input are noted where relevant.
Billing Code Overview
CPT code 78351 describes a diagnostic procedure that uses two different energy photon beams to measure bone mineral density (BMD). The test quantifies the mineral content of bone per unit area to evaluate conditions such as osteoporosis and to assess fracture risk.
Service Type: Diagnostic imaging — dual-energy photon absorptiometry for bone mineral density
Typical Site of Service: Outpatient imaging center or hospital outpatient department (radiology/bone densitometry suite)
Clinical & Coding Specifications
Clinical Context
A 67-year-old postmenopausal woman is referred by her primary care provider for bone mineral density (BMD) testing after a fragility wrist fracture and long-term corticosteroid therapy for polymyalgia rheumatica. The patient arrives at an outpatient imaging center for a dual-photon absorptiometry study using two different energy photon beams to measure BMD of the lumbar spine and proximal femur. The clinical workflow includes registration and verification of demographics and insurance, review of indications and prior imaging, screening for pregnancy (if applicable), removal of metallic objects, positioning on the scanning table, acquisition of lumbar spine and hip scans, generation of T-score and Z-score reports, technologist review for image quality, and transmission of the final report to the referring provider. The study is typically ordered to evaluate for osteoporosis, monitor response to therapy, or assess fracture risk.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the interpreting physician's professional service separate from technical component |
TC | Technical component | When billing only the facility/equipment/technologist portion of the service |