© Copyright 2025 American Medical Association. All rights reserved.
The Trabecular Bone Score (TBS) is a diagnostic tool designed to assess the structural condition of bone microarchitecture, specifically in relation to fracture risk. This evaluation is particularly relevant in the context of osteoporosis, a condition characterized by weakened bones that are more susceptible to fractures. The TBS is often utilized alongside a separate bone mineral density (BMD) examination, which is typically performed using dual X-ray absorptiometry (DXA). The TBS provides an indirect measurement of bone strength and microarchitecture without the need for invasive procedures. It operates by analyzing pixel gray-level variations from a previously acquired DXA image of the lower spine. In essence, the TBS evaluates the density and quality of trabecular bone, which is the spongy tissue found within bones. The method relies on the principle that different types of body tissues absorb X-rays differently, allowing for a detailed analysis of bone structure. A dense trabecular bone structure will exhibit a high number of pixel-to-pixel gray-scale variations with small amplitude, indicating a robust and fracture-resistant bone microarchitecture. Conversely, a porous bone structure will show fewer variations with higher amplitude, suggesting a weaker and more fracture-prone condition. The TBS score is derived from a variogram, which calculates the sum of squared gray-level differences between pixels in the DXA image. A higher TBS score indicates greater trabecular density and a stronger bone structure, while a lower score suggests increased fragility and a higher risk of fractures. The interpretation of the TBS score is performed by a qualified healthcare professional, who then provides a comprehensive report detailing the patient's fracture risk. This report is essential for guiding clinical decisions and managing the patient's osteoporosis treatment plan.
© Copyright 2025 Coding Ahead. All rights reserved.
The Trabecular Bone Score (TBS) is indicated for the assessment of fracture risk in patients with osteoporosis or those at risk of developing osteoporosis. The following conditions may warrant the use of TBS:
The procedure for obtaining a Trabecular Bone Score involves several key steps, which are outlined below:
Post-procedure care for patients undergoing TBS evaluation typically involves reviewing the results with the healthcare provider. The interpretation of the TBS score will inform the patient about their fracture risk and may lead to recommendations for further diagnostic testing, lifestyle modifications, or treatment options. Patients may also be advised on follow-up appointments to monitor their bone health and adjust treatment plans as necessary. It is important for patients to understand the significance of their TBS results and to engage in discussions regarding preventive measures and management strategies for osteoporosis.
| Short Descr | TBS I&R FX RSK QHP | Medium Descr | TBS INTERPRETATION & REPORT FX RISK BY OTHER QHP | Long Descr | Trabecular bone score (TBS), structural condition of the bone microarchitecture; interpretation and report on fracture-risk only by other qualified health care professional | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 2 - Professional 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 | 09 - Concept does not apply. | 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 | Items and Services Not Billable to the MAC | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
| MG | The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | 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 | GA | Waiver of liability statement issued as required by payer policy, individual case | CR | Catastrophe/disaster related | GZ | Item or service expected to be denied as not reasonable and necessary | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | MH | Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2022-01-01 | Added | Code added |
Get instant expert-level medical coding assistance.