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The Trabecular Bone Score (TBS) is a sophisticated method utilized for assessing osteoporosis and estimating an individual's risk of fractures. This evaluation is typically performed alongside a separate bone mineral density (BMD) examination. The TBS offers an indirect measurement of the microarchitecture and strength of bone in a non-invasive manner, which is crucial for understanding bone health. The process involves analyzing pixel gray-level variations derived from a previously obtained dual X-ray absorptiometry (DXA) image of the lower spine. DXA imaging operates on the principle that different types of body tissues absorb X-ray photons differently, utilizing both high and low energy X-ray beams. In the context of TBS, a dense trabecular bone structure will exhibit a significant number of pixel-to-pixel gray-scale variations with minimal amplitude, indicating a robust bone microarchitecture. Conversely, a porous bone structure will show fewer variations with greater amplitude, suggesting a weaker bone composition. The TBS calculation is based on a variogram, which quantifies the sum of squared gray-level differences between pixels in the DXA image. A higher TBS score indicates greater trabecular density and a stronger, more fracture-resistant bone microarchitecture, while a lower score suggests a weaker, more fracture-prone structure. The final TBS score is interpreted to provide a comprehensive report on the patient's fracture risk, which is essential for guiding clinical decisions and patient management.
© Copyright 2025 Coding Ahead. All rights reserved.
The Trabecular Bone Score (TBS) is indicated for the evaluation of osteoporosis and the prediction of fracture risk in patients. It is particularly useful in the following scenarios:
The procedure for obtaining a Trabecular Bone Score involves several key steps, which are detailed below:
After the TBS procedure, there are no specific post-procedure care requirements mentioned. However, it is essential for healthcare providers to review the TBS report in conjunction with other clinical findings and patient history to make informed decisions regarding osteoporosis management and fracture risk mitigation. Continuous monitoring and follow-up assessments may be necessary based on the patient's overall health status and risk factors.
| Short Descr | TBS TECHL CALCULATION ONLY | Medium Descr | TBS TECHNICAL CALCULATION ONLY | Long Descr | Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical calculation only | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 3 - Technical Component Only Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 01 - Procedure must be performed under the general supervision of a physician. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Procedure or Service, Not Discounted when Multiple | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| GA | Waiver of liability statement issued as required by payer policy, individual case | CR | Catastrophe/disaster related | GW | Service not related to the hospice patient's terminal condition | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary |
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| 2022-01-01 | Added | Code added |
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