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2025 CPT code 0556T

Assessment of bone strength and fracture risk using finite element analysis and bone mineral density data from a CT scan.

This code (0556T) is specifically for the assessment of bone strength, fracture risk, and bone mineral density. It should not be reported in conjunction with other components of bone strength and fracture risk assessment using finite element analysis and CT scan data, such as codes 0554T, 0555T, or 0557T.

Modifiers may be applicable. Refer to payer guidelines.

Medical necessity for this procedure must be documented. This might include factors such as osteoporosis, history of fractures, or family history of bone disorders that put the patient at risk.

The physician calculates bone strength and fracture risk using finite element analysis and CT scan data. This involves analyzing a set of equations to estimate the strength of bone and its response to various loads based on biomechanical testing. This code should only be reported for the provider’s assessment of bone mineral density, bone strength, and fracture risk.

In simple words: The doctor assesses your bone strength and risk of fracture using special computer calculations and a CT scan of your bones. This helps determine how strong your bones are and how likely they are to break.

This code represents the assessment of bone strength and fracture risk using finite element analysis of functional data, combined with bone mineral density data obtained from a computed tomography (CT) scan. It encompasses the calculation of bone strength and fracture risk using computer analysis of equations that estimate bone strength and response to various loads based on biomechanical testing of internal and external forces, bone architecture, structure, and material properties, along with bone mineral density determined by CT scanning.

Example 1: A 65-year-old female with osteoporosis undergoes a CT scan and finite element analysis to assess her bone strength and fracture risk., A 50-year-old male with a history of fractures needs an evaluation of his bone strength and fracture risk following a recent fall., A patient with a family history of osteoporosis is evaluated using a finite element analysis with CT to understand their current bone health and fracture risk. The physician uses this information to determine necessary preventative measures and/or treatment.

Documentation should include the CT scan results, the finite element analysis report, the physician's interpretation of the results, and the assessment of bone strength and fracture risk.

** As this is a Category III code, it is temporary and used for data collection. Coverage and payment policies may vary among payers. It is important to check with individual payers to determine coverage and reimbursement for this service.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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